Provider Demographics
NPI:1609839588
Name:RODRIGUEZ-MCDOUGALL, HARRY J (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:J
Last Name:RODRIGUEZ-MCDOUGALL
Suffix:
Gender:M
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 801210
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1210
Mailing Address - Country:US
Mailing Address - Phone:787-841-9922
Mailing Address - Fax:787-841-9922
Practice Address - Street 1:TORRE SAN CRISTOBAL
Practice Address - Street 2:SUITE 307
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-841-9922
Practice Address - Fax:787-841-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16380207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0024063Medicare PIN
PRI44136Medicare UPIN
PR24063Medicare PIN