Provider Demographics
NPI:1003017245
Name:ELIAS RODRIGUEZ, NORMA J (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:J
Last Name:ELIAS RODRIGUEZ
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:PO BOX 784
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-0784
Mailing Address - Country:US
Mailing Address - Phone:939-640-6385
Mailing Address - Fax:
Practice Address - Street 1:57 AVE LOPATEGUI
Practice Address - Street 2:APDO. 70
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4501
Practice Address - Country:US
Practice Address - Phone:939-640-6385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16447282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital