Provider Demographics
NPI:1346441383
Name:DR. JORGE L. RODRIGUEZ ORENGO,C.S.P.
Entity Type:Organization
Organization Name:DR. JORGE L. RODRIGUEZ ORENGO,C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-267-5222
Mailing Address - Street 1:D3 CALLE JASPE
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-2837
Mailing Address - Country:US
Mailing Address - Phone:787-856-8794
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE DR PASARELL
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3657
Practice Address - Country:US
Practice Address - Phone:787-267-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty