Provider Demographics
NPI:1750497103
Name:RODRIGUEZ, RAMON L (MD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-1006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL MENONITA COAMO
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00769
Practice Address - Country:UM
Practice Address - Phone:787-455-0022
Practice Address - Fax:787-845-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine