Provider Demographics
NPI:1003554270
Name:RODRIGUEZ, JYM CARLO (MD)
Entity Type:Individual
Prefix:
First Name:JYM
Middle Name:CARLO
Last Name:RODRIGUEZ
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:UROYAN ST
Mailing Address - Street 2:URB. ALTURAS DE MAYAGUEZ
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-519-1794
Mailing Address - Fax:
Practice Address - Street 1:URB. ALTURAS DE MAYAGUEZ
Practice Address - Street 2:UROYAN ST. #1101
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-519-1794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program