Provider Demographics
NPI:1164646675
Name:RODRIGUEZ, FELIX (PT)
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 61 BLOQUE 67 12
Mailing Address - Street 2:URB SIERRA BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-730-4741
Mailing Address - Fax:
Practice Address - Street 1:CALLE 61 BLOQUE 67 12
Practice Address - Street 2:URB SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-730-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0001OtherPT