Provider Demographics
NPI:1619170842
Name:RODRIGUEZ RUIZ, CARMEN ROCIO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN ROCIO
Middle Name:
Last Name:RODRIGUEZ RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROCIO
Other - Middle Name:R
Other - Last Name:SOUCHET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2114 CALLE MILETO
Mailing Address - Street 2:ALTO APOLO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4928
Mailing Address - Country:US
Mailing Address - Phone:787-579-0055
Mailing Address - Fax:
Practice Address - Street 1:2114 CALLE MILETO
Practice Address - Street 2:ALTO APOLO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4928
Practice Address - Country:US
Practice Address - Phone:787-579-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14611208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice