Provider Demographics
NPI:1073728176
Name:RODRIGUEZ, JOSE A
Entity Type:Individual
Prefix:MRS
First Name:JOSE
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:A
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TECH
Mailing Address - Street 1:CALLE AA BLQ FF
Mailing Address - Street 2:SUITE # 26 ALTURAS DE VEGA BAJA
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-314-0389
Mailing Address - Fax:
Practice Address - Street 1:CALLE AA BLQ FF
Practice Address - Street 2:SUITE # 26 ALTURAS DE VEGA BAJA
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-314-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician