Provider Demographics
NPI:1053780387
Name:RULLAN OLIVER, BIANCA EMILIA (MD)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:EMILIA
Last Name:RULLAN OLIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 AVE PONCE DE LEON STE 512
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-5027
Mailing Address - Country:US
Mailing Address - Phone:787-751-1910
Mailing Address - Fax:787-282-7131
Practice Address - Street 1:735 AVE PONCE DE LEON STE 512
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5027
Practice Address - Country:US
Practice Address - Phone:787-751-1910
Practice Address - Fax:787-282-7131
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD470238207Y00000X
PR22528207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology