Provider Demographics
NPI:1003815879
Name:RODRIGUEZ ALMODOVAR, RAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL A
Middle Name:
Last Name:RODRIGUEZ ALMODOVAR
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 132
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-0132
Mailing Address - Country:US
Mailing Address - Phone:787-807-3703
Mailing Address - Fax:787-807-3703
Practice Address - Street 1:4 CALLE JOSE JULIAN ACOSTA
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4469
Practice Address - Country:US
Practice Address - Phone:787-807-3703
Practice Address - Fax:787-807-3703
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89944Medicare ID - Type Unspecified
PRH82130Medicare UPIN