Provider Demographics
NPI:1295829984
Name:RODRIGUEZ, ANGEL L (BS, CRT, RRT)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:BS, CRT, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:US
Mailing Address - Phone:787-317-2012
Mailing Address - Fax:
Practice Address - Street 1:BO. YAHUECAS CARR PR 135 KM 75
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-317-2012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR91OtherRESPIRATORY THERAPIST