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Individual

MR. RHADAMES TRINIDAD VIDALOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
CARR 21 LAS LOMAS, RIO PIEDRAS, PR 00983
(787) 782-8058
(787) 782-8058
Mailing address
CONDOMINIO COSTA MARINA II, APARTAMENTO 3J, CAROLINA, PR 00983
(787) 378-3130
(787) 378-3130

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6178
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0061085
LA CRUZ AZUL DE PUERTO RI
01
228011
PREFERRED HEALTH PLAN
01
2473
PREFERRED MEDICAL CHOICE
01
27446
TRIPLE S
01
500043E
MEDICARE MUCHO MAS MMM
Enumeration date
08/30/2006
Last updated
12/29/2010
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