Provider Demographics
NPI:1174502488
Name:RODRIGUEZ-MUNOZ, ANDRES (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:RODRIGUEZ-MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 COMMUNICATION WAY
Mailing Address - Street 2:UNIT 1D
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1883
Mailing Address - Country:US
Mailing Address - Phone:508-790-4094
Mailing Address - Fax:508-790-0899
Practice Address - Street 1:270 COMMUNICATION WAY
Practice Address - Street 2:UNIT 1D
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1883
Practice Address - Country:US
Practice Address - Phone:508-790-4094
Practice Address - Fax:508-790-0899
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA582262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2146657Medicaid
MAG39594Medicare UPIN
MAA32116Medicare PIN