Provider Demographics
NPI:1447218367
Name:RODRIGUEZ, GILBERTO
Entity Type:Individual
Prefix:MR
First Name:GILBERTO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:
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 1911
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-1911
Mailing Address - Country:US
Mailing Address - Phone:787-431-3774
Mailing Address - Fax:
Practice Address - Street 1:JUAN HERNANDEZ AVE.
Practice Address - Street 2:#15 ESQUINA AGUSTIN R. CALERO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-431-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057746Medicare ID - Type UnspecifiedAMBULANCE SUPPLIER