Provider Demographics
NPI:1073998449
Name:RODRIGUEZ HERNANDEZ, AIDA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:MARIA
Last Name:RODRIGUEZ HERNANDEZ
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 1471
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1471
Mailing Address - Country:US
Mailing Address - Phone:787-344-1189
Mailing Address - Fax:
Practice Address - Street 1:VA CARIBBEAN HEALTHCARE SYSTEM
Practice Address - Street 2:10 CALLE CASIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3201
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21009208M00000X, 207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty