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Individual

DR. ROQUE CESAR NIDO LANAUSSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3 CALLEJON LOS VETERANOS, GUAYAMA MEDICAL CENTER, 1ST FLOOR, GUAYAMA, PR 00784-5984
(787) 864-1012
(787) 866-2125
Mailing address
PO BOX 180, GUAYAMA, PR 00785-0180
(787) 864-1012
(787) 866-2125

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7453
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
066139
CRUZ AZUL
PR
01
1173
INTERNATIONAL MEDICAL CAR
PR
01
2-04001
PREFERRED
PR
01
3307453
UIA
PR
01
600564
MMM
PR
01
6550006
HUMANA
PR
01
99248NI
SSS
PR
01
M-115
MENONITA
PR
01
PE-1451
PALIC PROVIDER
PR
Enumeration date
09/12/2005
Last updated
03/10/2011
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