Provider Demographics
NPI:1467533612
Name:RODRIGUEZ, CARLOS OMAR (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:OMAR
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5307
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5307
Mailing Address - Country:US
Mailing Address - Phone:787-743-2378
Mailing Address - Fax:787-743-1225
Practice Address - Street 1:C-2 CONSOLIDATED MALL AVE. GAUTIER BENITEZ
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-5307
Practice Address - Country:US
Practice Address - Phone:787-743-2378
Practice Address - Fax:787-743-1225
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14680207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease