Provider Demographics
NPI:1356620207
Name:CUMBA-BERMUDEZ, RICARDO J (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:J
Last Name:CUMBA-BERMUDEZ
Suffix:
Gender:M
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:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0130
Mailing Address - Country:US
Mailing Address - Phone:787-786-2050
Mailing Address - Fax:787-780-3774
Practice Address - Street 1:12-20 AVE AGUAS BUENAS
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6623
Practice Address - Country:US
Practice Address - Phone:787-786-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18490207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology