Provider Demographics
NPI:1851656672
Name:RODRIGUEZ RIVERA, LAURA E (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:RODRIGUEZ RIVERA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:609 TITO CASTRO AVE
Mailing Address - Street 2:SUITE 102 PMB 370
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0020
Mailing Address - Country:US
Mailing Address - Phone:787-259-3355
Mailing Address - Fax:
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:SUITE 723 TORRE MEDICA SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4725
Practice Address - Country:US
Practice Address - Phone:787-259-3355
Practice Address - Fax:787-844-3003
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
PR19591208600000X
PR29481208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery