Provider Demographics
NPI:1093774085
Name:RODRIGUEZ, RUTH E (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:E
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:URB. COUNTRY CLUB
Mailing Address - Street 2:1007 CALLE CARMEN BUZELLO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-760-5545
Mailing Address - Fax:787-760-5545
Practice Address - Street 1:BO. DOS BOCAS
Practice Address - Street 2:CARR. 181 KM. 9.1
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-760-5545
Practice Address - Fax:787-760-5545
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5363208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5363OtherSTATE LICENSE