Provider Demographics
NPI:1821001140
Name:RODRIGUEZ, GILBERTO (MD)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
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 1387
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1387
Mailing Address - Country:US
Mailing Address - Phone:787-826-0090
Mailing Address - Fax:787-826-0090
Practice Address - Street 1:CARR 401 KM 0.5 BO PLAYA
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-0090
Practice Address - Fax:787-826-0090
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10415208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100289WOtherMMM
PR201062OtherUTI
PR6810001OtherHUMANA
PR8000OtherINTERNATIONAL MEDICAL CAR
PR87982OtherSSS
PR080088OtherCRUZ AZUL
PR3310415OtherUIA
PR201062OtherUTI
PR100289WOtherMMM