Doctor Name: | DR. CRISTOBAL RODRIGUEZ |
NPI Number: | 1194856377 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 15137 |
Business Practice Address: | 255 Ave Ponce De Leon Mcs Plaza Pmb#154 Suite 75 San Juan, PR - 009171919 |
Business Phone Number: | 7877582500 |
Business Fax Number: | |
Mailing Address: | Palacios Del Rio Ii Blanco St. I-2, Box 664 TOA ALTA |
State: | PR |
Postal Code: | 00953 |
Phone Number: | 7879994844 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 15137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |