Provider Demographics
NPI:1669502779
Name:RODRIGUEZ, HECTOR A (RPH)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CALLE BARCELO
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1734
Mailing Address - Country:US
Mailing Address - Phone:787-857-4635
Mailing Address - Fax:787-857-5290
Practice Address - Street 1:14 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1734
Practice Address - Country:US
Practice Address - Phone:787-857-4635
Practice Address - Fax:787-857-5290
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist