Doctor Name: | EDWIN RODRIGUEZ |
NPI Number: | 1174667281 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | DM150128 |
Business Practice Address: | Legacy Office Park Suite102 Carr 506, Km 0.75 Coto Laurel, PR - 00780 |
Business Phone Number: | 7872591654 |
Business Fax Number: | |
Mailing Address: | Po Box 10614, PONCE |
State: | PR |
Postal Code: | 007320614 |
Phone Number: | 7872591654 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 04/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | DM150128 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |