Provider Demographics
NPI:1235215476
Name:RODRIGUEZ SILVA, WILMER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILMER
Middle Name:
Last Name:RODRIGUEZ SILVA
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 1:100 PASEO SAN PABLO
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-780-4297
Mailing Address - Fax:787-798-3110
Practice Address - Street 1:100 PASEO SAN PABLO
Practice Address - Street 2:SUITE 104
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-780-4297
Practice Address - Fax:787-798-3110
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6509207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D99608Medicare UPIN
PR28723Medicare ID - Type Unspecified