Provider Demographics
NPI:1306539663
Name:BOU ROLON, SHAKIRA (MD)
Entity type:Individual
Prefix:
First Name:SHAKIRA
Middle Name:
Last Name:BOU ROLON
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:LUIS A FERRE HIGHWAY, EXIT #21 ROAD 172 CAGUAS TO CIDRA
Mailing Address - Street 2:TURABO GARDENS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-743-3038
Mailing Address - Fax:
Practice Address - Street 1:100 AVE LAUREL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4816
Practice Address - Country:US
Practice Address - Phone:787-787-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37696207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine