Provider Demographics
NPI:1518083211
Name:RODRIGUEZ, MARIA DE LOS ANGELES (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:RODRIGUEZ
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:URB ARBOLADA
Mailing Address - Street 2:A17 CALLE YAGRUMO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1301
Mailing Address - Country:US
Mailing Address - Phone:787-637-5901
Mailing Address - Fax:787-776-2202
Practice Address - Street 1:101 CALLE NARCISO FONT E
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-6124
Practice Address - Country:US
Practice Address - Phone:787-776-2202
Practice Address - Fax:787-776-2202
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14285208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH79742Medicare UPIN