Provider Demographics
NPI:1467907352
Name:RODRIGUEZ TIRADO, KARLA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:MARIE
Last Name:RODRIGUEZ TIRADO
Suffix:
Gender:F
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 521
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-0521
Mailing Address - Country:US
Mailing Address - Phone:787-929-1505
Mailing Address - Fax:
Practice Address - Street 1:165 CALLE BALDORIOTY N
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3234
Practice Address - Country:US
Practice Address - Phone:787-694-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21712207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program