Doctor Name: | PEDRO ANGEL LEBRON RUIZ |
NPI Number: | 1164886404 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 13899I |
Business Practice Address: | Calle 1 Casa A8 Jardines De Guatemala San Sebastian, PR - 00685 |
Business Phone Number: | 7872156357 |
Business Fax Number: | |
Mailing Address: | Calle 1 Casa A8, Jardines De Guatemala SAN SEBASTIAN |
State: | PR |
Postal Code: | 00685 |
Phone Number: | 7872156357 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2016 |
NPI Last Update Date: | 04/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13899I |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |