Provider Demographics
NPI:1568864676
Name:RODRIGUEZ PEREZ, ANTONIO (DC)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:RODRIGUEZ PEREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 AVE SAN CLAUDIO
Mailing Address - Street 2:SUITE #377
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4143
Mailing Address - Country:US
Mailing Address - Phone:787-414-9898
Mailing Address - Fax:787-561-7464
Practice Address - Street 1:PLAZA MARINA SUITE #13
Practice Address - Street 2:535 CARR. 189 KM. 6.40
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-4202
Practice Address - Country:US
Practice Address - Phone:787-414-9898
Practice Address - Fax:787-561-7464
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11299111N00000X
PR544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor