Provider Demographics
NPI:1679660286
Name:APONTE RODRIGUEZ, JOSE TOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:TOMAS
Last Name:APONTE RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:TOMAS
Other - Last Name:APONTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1870 GRAND CONCOURSE FL 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5402
Mailing Address - Country:US
Mailing Address - Phone:347-205-8280
Mailing Address - Fax:347-205-8998
Practice Address - Street 1:1870 GRAND CONCOURSE FL 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5402
Practice Address - Country:US
Practice Address - Phone:347-205-8280
Practice Address - Fax:347-205-8998
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2531552080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02520414Medicaid