Provider Demographics
NPI:1629002134
Name:CUAUTLI RODRIGUEZ, MARIA ALEJANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ALEJANDRA
Last Name:CUAUTLI 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 1500
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-1500
Mailing Address - Country:US
Mailing Address - Phone:787-894-8880
Mailing Address - Fax:
Practice Address - Street 1:PR-111 KM 1.8
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-1500
Practice Address - Country:US
Practice Address - Phone:787-894-8880
Practice Address - Fax:787-894-8880
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10328208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-4556(CU)OtherTRIPLE S PROVIDER NUMBER
PR8-4556(CU)OtherTRIPLE S PROVIDER NUMBER
PRF-18926Medicare UPIN