Provider Demographics
NPI:1821392044
Name:RODRIGUEZ-GONZALEZ, CARMEN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ELIZABETH
Last Name:RODRIGUEZ-GONZALEZ
Suffix:
Gender:F
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 1012
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1012
Mailing Address - Country:US
Mailing Address - Phone:787-453-0107
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 365 PLAZA MONSERRATE 3 LOCAL 4
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-245-9802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18119207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18119OtherPROFESSIONAL LICENSE