Provider Demographics
NPI:1538126891
Name:ANGEL D. RODRIGUEZ
Entity Type:Organization
Organization Name:ANGEL D. RODRIGUEZ
Other - Org Name:RODRIGUEZ FIRST RESPONDER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-837-3098
Mailing Address - Street 1:HC 01 BOX 31240
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9750
Mailing Address - Country:US
Mailing Address - Phone:787-837-3098
Mailing Address - Fax:787-837-7198
Practice Address - Street 1:BO. TIJERAS CARR .
Practice Address - Street 2:# 14 K.M 17.3
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-9750
Practice Address - Country:US
Practice Address - Phone:787-837-3098
Practice Address - Fax:787-837-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB273341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005-3540Medicare PIN