Provider Demographics
NPI:1659423812
Name:RODRIGUEZ, JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:RAFAEL
Other - Last Name:RODRIGUEZ-RAMOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4041
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4041
Mailing Address - Country:US
Mailing Address - Phone:787-872-1499
Mailing Address - Fax:787-882-8882
Practice Address - Street 1:115 CALLE EMILIO GONZALEZ
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2656
Practice Address - Country:US
Practice Address - Phone:787-872-1499
Practice Address - Fax:787-882-8882
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine