Provider Demographics
NPI:1033186234
Name:RODRIGUEZ, MARANGELY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARANGELY
Middle Name:
Last Name: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 688
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718-0688
Mailing Address - Country:US
Mailing Address - Phone:787-374-6655
Mailing Address - Fax:787-852-0515
Practice Address - Street 1:AVE FONT MARTELO #303
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-931-7555
Practice Address - Fax:407-386-7022
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14543208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-48867Medicare UPIN