Provider Demographics
NPI:1851067441
Name:RODRIGUEZ AROCHO, KEVIN IVAN
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:IVAN
Last Name:RODRIGUEZ AROCHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:QUANTUM METROCENTER II
Mailing Address - Street 2:AVENIDA CHARDON APT 143
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-938-2041
Mailing Address - Fax:
Practice Address - Street 1:QUANTUM METROCENTER II
Practice Address - Street 2:AVENIDA CHARDON APT 143
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-938-2041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program