MEDICARE: HENRY ALEXANDER RUBERTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	6189936	PR
2	207UN0902X	Nuclear Imaging & Therapy Physician	23813	PR

General Provider Information

NPI Number	:	1376153536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY ALEXANDER RUBERTE MD

Provider Business Mailing Address
First Line	:	PO BOX 60327
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-6032
Country	:	US
Telephone Number	:	787-798-3001
Fax Number	:	787-778-0460

Provider Business Practice Location Address
First Line	:	CENTRO MEDICO DE PUERTO RICO BARRIO MONACILLOS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00935-4816
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	03/25/2025

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