Provider Demographics
NPI:1154355931
Name:ONGAY RULLAN, JAIME (MD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:ONGAY RULLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PUERTO GALEXDA
Mailing Address - Street 2:CALLE MARBELLA #9
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-3144
Mailing Address - Country:US
Mailing Address - Phone:787-402-4343
Mailing Address - Fax:787-815-0641
Practice Address - Street 1:89 CALLE HOSTOS
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2660
Practice Address - Country:US
Practice Address - Phone:787-402-4343
Practice Address - Fax:787-740-6261
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14976208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice