Provider Demographics
NPI:1114511193
Name:GARCIA-RODRIGUEZ, CARLOS E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:GARCIA-RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CALLE LUIS MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-3225
Mailing Address - Country:US
Mailing Address - Phone:787-314-3377
Mailing Address - Fax:
Practice Address - Street 1:24 CALLE LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-3225
Practice Address - Country:US
Practice Address - Phone:787-314-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6456370Medicaid