Provider Demographics
NPI:1417997669
Name:RODRIGUEZ, JOSE G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:G
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:COND EL CID
Mailing Address - Street 2:660 AVE MIRAMAR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-3452
Mailing Address - Country:US
Mailing Address - Phone:787-798-3001
Mailing Address - Fax:787-269-1352
Practice Address - Street 1:COND EL CID
Practice Address - Street 2:660 AVE MIRAMAR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3452
Practice Address - Country:US
Practice Address - Phone:787-798-3001
Practice Address - Fax:787-269-1352
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2019-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR8108208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice