Provider Demographics
NPI:1164102828
Name:RODRIGUEZ RIVERA, ALEXIS G (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:G
Last Name:RODRIGUEZ RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GLORIVEE
Other - Middle Name:
Other - Last Name:RODRIGUEZ RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11833 CALLE REY ALFONSO X
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-5208
Mailing Address - Country:US
Mailing Address - Phone:787-629-3528
Mailing Address - Fax:
Practice Address - Street 1:11833 CALLE REY ALFONSO X
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-5208
Practice Address - Country:US
Practice Address - Phone:787-629-3528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath