Provider Demographics
NPI:1386803641
Name:RD PULMONARY SERVICES CSP
Entity type:Organization
Organization Name:RD PULMONARY SERVICES CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-880-2996
Mailing Address - Street 1:PO BOX 141057
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1057
Mailing Address - Country:US
Mailing Address - Phone:787-880-2996
Mailing Address - Fax:787-880-2988
Practice Address - Street 1:AVE RAFAEL RIVERA AULET #406
Practice Address - Street 2:ESQ TRINA PADILLA SANZ AL LADO HOSPITAL MUNICIPAL
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-880-2996
Practice Address - Fax:787-880-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10915207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty