Provider Demographics
NPI:1124002670
Name:RODRIGUEZ RODRIGUEZ, JOSE F (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:F
Last Name:RODRIGUEZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PMB 201/200 AVE R CORDERO STE 140
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-467-7268
Mailing Address - Fax:787-850-4815
Practice Address - Street 1:355 AVE FONT MARTELO
Practice Address - Street 2:STE 401 HOSPITAL RYDER
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-850-4815
Practice Address - Fax:787-850-4815
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1100963OtherACAA
PR0400229OtherHUMANA HEALTH
PR0400229OtherHUMANA INSURANCE
PR2706OtherPREFERRED MEDICARE CHOICE
PR4307760OtherUIA
PR212360OtherUTI
PRN036OtherINTERNATIONAL MEDICAL
PR4307760OtherUIA
PR2706OtherPREFERRED MEDICARE CHOICE