Provider Demographics
NPI:1790862936
Name:RODRIGUEZ-GONZALEZ, LUZ E (MT)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:E
Last Name:RODRIGUEZ-GONZALEZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:AVE LOMAS VERDES 1C 14B
Mailing Address - Street 2:PMB 168
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-798-4747
Mailing Address - Fax:787-740-8395
Practice Address - Street 1:ROAD 174 KM 5 8
Practice Address - Street 2:BARRIO GUARAGUAO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-798-4747
Practice Address - Fax:787-740-8395
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30967Medicare ID - Type Unspecified