Provider Demographics
NPI:1669448809
Name:RODRIGUEZ, SANDRA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:S
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 16323
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-6323
Mailing Address - Country:US
Mailing Address - Phone:787-728-3441
Mailing Address - Fax:787-287-2610
Practice Address - Street 1:253 CALLE SAN JORGE
Practice Address - Street 2:2A SUITE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3307
Practice Address - Country:US
Practice Address - Phone:787-728-3441
Practice Address - Fax:787-287-2610
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9534208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics