Basic Information
| Provider Information | |||||||||
| NPI: | 1356328561 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REY LABORDE | ||||||||
| FirstName: | ROSARIO | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | URB PLAZA DE LA FUENTE | ||||||||
| Address2: | 1199 CALLE BRAZIL | ||||||||
| City: | TOA ALTA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009530000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879031444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL PAVIA | ||||||||
| Address2: | CALLE PROFESOR AUGUSTO # 1462 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009100000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876411616 | ||||||||
| FaxNumber: | 7877282641 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2005 | ||||||||
| LastUpdateDate: | 01/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 016121 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.