Provider Demographics
NPI:1033558291
Name:RODRIGUEZ COSME, YESSENIA (MD)
Entity Type:Individual
Prefix:
First Name:YESSENIA
Middle Name:
Last Name:RODRIGUEZ COSME
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 14457
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4457
Mailing Address - Country:US
Mailing Address - Phone:787-268-4171
Mailing Address - Fax:
Practice Address - Street 1:OFICINA DE RESIDENTES DR ANTONIO ORTIZ HOPU
Practice Address - Street 2:BARRIO BONACILLOS CARRETERA 22
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-299-4875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19732208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics