Provider Demographics
NPI:1003221458
Name:RODRIGUEZ BURY, VINCENT X (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:X
Last Name:RODRIGUEZ BURY
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 364641
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4641
Mailing Address - Country:US
Mailing Address - Phone:787-432-5609
Mailing Address - Fax:
Practice Address - Street 1:DOCTORS CENTER HOSPITAL CAROLINA
Practice Address - Street 2:AVE FERNANDEZ JUNCOS EDIFICIO JESUS T PINERO BO PUEBLO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-6179
Practice Address - Country:US
Practice Address - Phone:787-626-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21356208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty