Mayra Rullan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

146 Issued in PR

Practice address

118 Calle Eleonor Roosevelt
Iau School of Optometry
San Juan, PR 00918-3105

Phone

(787) 765-1915

NPI assigned

Jun 4, 2007

Last updated

Oct 16, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mayra Rullan Rivera Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1962604777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 CALLE MIRAMONTE",
            "address_2": "GRAN VISTA I",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007785007",
            "telephone_number": "787-765-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CALLE ELEONOR ROOSEVELT",
            "address_2": "IAU SCHOOL OF OPTOMETRY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183105",
            "telephone_number": "787-765-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULLAN",
        "first_name": "MAYRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYRA",
            "last_name": "RULLAN RIVERA",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bianca Emilia Rullan Oliver, M.D.
• Rullan Sinus Surgical Center LLC
• Viviana Rullan Varela
• Wendeline Rullan Vega
• Maria Del Carmen Rullan, MD, MPH
• Paulina Del Mar Rullan
• Ramon G Rullan
• Libertad Isabel Ruscalleda Reyes, M.D.
• Mariaisabel Russe Russe
• Carlos Jose Russe-Russe

• Optometrist in San Juan, PR
• Providers in San Juan, PR by specialty
• Optometrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.