Luis Rafael Polo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

14229 Issued in PR

Practice address

29 Calle Washington
Suite 609
San Juan, PR 00907-1510

Phone

(787) 725-0788

NPI assigned

Jan 26, 2006

Last updated

Sep 17, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1447220777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEADOWS TOWER, #H-3 SAN PATRICIO AVENUE",
            "address_2": "BOX 14",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-775-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CALLE WASHINGTON",
            "address_2": "SUITE 609",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071510",
            "telephone_number": "787-725-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLO",
        "first_name": "LUIS",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "14229",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "14229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Policlinica Rio Piedras
• Nicole Marie Polish
• Marthely Pollas
• Mario Javier Polo Asenjo, M.D.
• Luis M Polo, M.D.
• Mario Polo, DMD,MS
• Ana M Pomales Ayala, RN
• Gabriela Cristina Pomales
• Sari Y Pomales
• Ponce Cardio Imaging, PSC

• Psychiatry Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Psychiatry Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.