Basic Information
| Provider Information | |||||||||
| NPI: | 1205281904 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RRSM PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12213 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009140213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874395326 | ||||||||
| FaxNumber: | 7878541452 | ||||||||
| Practice Location | |||||||||
| Address1: | 1451 AVE ASHFORD | ||||||||
| Address2: | CLINICAS PM&R | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009071511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874395326 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2016 | ||||||||
| LastUpdateDate: | 04/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | RIEFKOHL | ||||||||
| AuthorizedOfficialFirstName: | RICARDO | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7874395326 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081S0010X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine |
No ID Information.