Doctor Name: | MR. CARLOS EDUARDO RODRIGUEZ |
NPI Number: | 1174963409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 019217 |
Business Practice Address: | Sergio Cuevas Bustamante St 550 Ave Domenech San Juan, PR - 00918 |
Business Phone Number: | 2693692913 |
Business Fax Number: | |
Mailing Address: | Po Box 364708, SAN JUAN |
State: | PR |
Postal Code: | 009364708 |
Phone Number: | 2693692913 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 03/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 019217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |