Provider Demographics
NPI:1639116262
Name:RODRIGUEZ, OSCAR JAVIER (MD)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:JAVIER
Last Name:RODRIGUEZ
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 1:1937 LAS AMERICAS AVE
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1815
Mailing Address - Country:US
Mailing Address - Phone:787-424-8554
Mailing Address - Fax:787-824-7689
Practice Address - Street 1:156 CALLE BARCELO # 53
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1621
Practice Address - Country:US
Practice Address - Phone:787-857-2688
Practice Address - Fax:787-857-1730
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14400208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22996Medicare PIN
PRI33335Medicare UPIN