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NPI Code Detail

MEDICARE: POLICLINICA RIO PIEDRAS

MEDICARE: POLICLINICA RIO PIEDRAS
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
1208D00000XGeneral Practice PhysicianPR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1500363EOTHERPRMMM
2600600262OTHERPRCOSVI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
431626OTHERPRUIA
5061917OTHERPRCRUZ AZUL
6201873OTHERPRPREFERRED
740073OTHERPRPREFERRED CHOICE
884715OTHERPRTRIPLE-S
9500360EOTHERPRMMM
10500409EOTHERPRMMM

General Provider Information

NPI Number : 1841280534
Entity Type Code : Organization
Provider Name (Legal Business Name) : POLICLINICA RIO PIEDRAS
Provider Business Mailing Address
First Line : 1056 CALLE FERROCARRIL
Second Line : SUITE 1
City : SAN JUAN
State : PR
Zip : 00925-3028
Country : US
Telephone Number : 787-764-8937
Fax Number : 787-763-4278
Provider Business Practice Location Address
First Line : 1056 CALLE FERROCARRIL
Second Line : SUITE 1
City : SAN JUAN
State : PR
Zip : 00925-3028
Country : US
Telephone Number : 787-764-8937
Fax Number : 787-763-4278
Authorized Official
Title or Position : PRESIDENT
Name : ARIEL A. ROJAS FABREGAT
Credential :
Telephone Number : 787-764-8937
Provider Enumeration Date : 10/25/2005
Last Update Date : 07/11/2025

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1003955501 — DR. AIDA M LIZASOAIN SANTIAGO MD
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Directions to “POLICLINICA RIO PIEDRAS ” Practice Location

Language Start Address Practice Location
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