Provider Demographics
NPI:1558903187
Name:ENGEL-RODRIGUEZ, ANDREW JACOB (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JACOB
Last Name:ENGEL-RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:JACOB
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:54 AVE ATLANTICO
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2109
Mailing Address - Country:US
Mailing Address - Phone:787-677-3029
Mailing Address - Fax:
Practice Address - Street 1:VA CARIBBEAN HEALTHCARE SYSTEM
Practice Address - Street 2:10 CALLE CASIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR35834208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program