Provider Demographics
NPI:1639198088
Name:RODRIGUEZ, HECTOR ADALID (RPT)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:ADALID
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPT
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 101
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0101
Mailing Address - Country:US
Mailing Address - Phone:787-894-3987
Mailing Address - Fax:787-814-1105
Practice Address - Street 1:44 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2878
Practice Address - Country:US
Practice Address - Phone:787-894-3987
Practice Address - Fax:787-680-0199
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6410021OtherHUMANA
660547741OtherCIGNA
PR3303144OtherACCA
PR04360OtherAMERICAN HEALTH, INC
2931-5OtherPROSSAM
PR89205OtherTRIPLE-S
PR9000598OtherLA CRUZ AZUL DE PR
PR9000598OtherLA CRUZ AZUL DE PR