Provider Demographics
NPI:1467413633
Name:RODRIGUEZ-BECERRA, JAVIER J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:J
Last Name:RODRIGUEZ-BECERRA
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 1:400 CALLE KALAF
Mailing Address - Street 2:PMB 59
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1314
Mailing Address - Country:US
Mailing Address - Phone:787-854-7270
Mailing Address - Fax:
Practice Address - Street 1:URB FLAMBOYAN
Practice Address - Street 2:CALLE MCKINLEY I 26
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5438
Practice Address - Country:US
Practice Address - Phone:787-854-7270
Practice Address - Fax:787-857-1737
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13598207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1-16018Medicare UPIN
PR002-1885Medicare ID - Type Unspecified