# PEDRO J RULLAN MARIN MEDICAL SERVICES, CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891194478
- **Authorized official:** PEDRO J RULLAN MARIN MD, FACS (OWNER)
- **Authorized official phone:** (787) 751-1910

## Contact information

- **Practice address:** 735 AVE PONCE DE LEON, TORRE AUXILIO MUTUO \# 512, SAN JUAN, PR 00917-5022
- **Practice address phone:** (787) 751-1910
- **Mailing address:** 735 AVE PONCE DE LEON, TORRE AUXILIO MUTUO \# 512, SAN JUAN, PR 00917-5022
- **Mailing address phone:** (787) 751-1910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 8708 | PR | Yes |
| 207YP0228X | Pediatric Otolaryngology Physician | 8708 | PR | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 8708 | PR | — |

## Other

- **Enumeration date:** 08/19/2014
- **Last updated:** 08/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0081379 | PTAN | PR |