Provider Demographics
NPI:1811034077
Name:RODRIGUEZ NAVARRO, HECTOR RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:RAFAEL
Last Name:RODRIGUEZ NAVARRO
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 1:1025 GRAND CONCOURSE AVE.
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452
Mailing Address - Country:US
Mailing Address - Phone:718-681-4242
Mailing Address - Fax:718-681-7608
Practice Address - Street 1:1025 GRAND CONCOURSE AVE.
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452
Practice Address - Country:US
Practice Address - Phone:718-681-4242
Practice Address - Fax:718-681-7608
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152348-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY83A091Medicare ID - Type UnspecifiedMEDICARE PROVIDER