Provider Demographics
NPI:1386848380
Name:RODRIGUEZ-SALLABERRY, FRITZ EMMANUEL (MD)
Entity Type:Individual
Prefix:
First Name:FRITZ
Middle Name:EMMANUEL
Last Name:RODRIGUEZ-SALLABERRY
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:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1866
Mailing Address - Country:US
Mailing Address - Phone:787-818-6010
Mailing Address - Fax:
Practice Address - Street 1:CONCEPCION VERA AYALA STREET #550
Practice Address - Street 2:HOSPITAL SAN CARLOS
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11952207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology