Provider Demographics
NPI:1740216530
Name:ALMODOVAR-RODRIGUEZ, NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:ALMODOVAR-RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NELSON
Other - Middle Name:
Other - Last Name:ALMODOVAR-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:293 PASEO DEL FLAMBOYAN
Mailing Address - Street 2:EL VALLE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3220
Mailing Address - Country:US
Mailing Address - Phone:787-977-0537
Mailing Address - Fax:787-721-3646
Practice Address - Street 1:160 AVE WINSTON CHURCHILL
Practice Address - Street 2:CROWN HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6013
Practice Address - Country:US
Practice Address - Phone:787-763-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics