Provider Demographics
NPI:1417949728
Name:NARVAEZ RODRIGUEZ, TOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:
Last Name:NARVAEZ RODRIGUEZ
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 1363
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-1363
Mailing Address - Country:US
Mailing Address - Phone:787-894-1488
Mailing Address - Fax:787-894-1488
Practice Address - Street 1:340 CALLE FERNANDO L GARCIA
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-3035
Practice Address - Country:US
Practice Address - Phone:787-894-1488
Practice Address - Fax:787-894-1488
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5032208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26592OtherSSS
PR65067OtherCA
PR15081OtherAMPR
PR2425OtherIMC
PR2425OtherIMC
PR26592OtherSSS