Provider Demographics
NPI:1598843153
Name:RODRIGUEZ, ROSA ADELAIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ADELAIDA
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:PO BOX 362334
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2334
Mailing Address - Country:US
Mailing Address - Phone:787-751-0715
Mailing Address - Fax:787-751-0435
Practice Address - Street 1:66 CALLE GEORGETTI STE 202
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3607
Practice Address - Country:US
Practice Address - Phone:787-751-0715
Practice Address - Fax:787-751-0435
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5430261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty