Provider Demographics
NPI:1851923429
Name:RODRIGUEZ ROSSELLO, VICTOR GUILLERMO (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:GUILLERMO
Last Name:RODRIGUEZ ROSSELLO
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:CLL VIA SAN PAOLO G6
Mailing Address - Street 2:MONTE ALVERIA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7427
Mailing Address - Country:US
Mailing Address - Phone:787-449-1424
Mailing Address - Fax:
Practice Address - Street 1:CARR 21 NUM 1785, AVE LAS LOMAS #21
Practice Address - Street 2:HOSPITAL METROPOLITANO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-0000
Practice Address - Country:US
Practice Address - Phone:787-782-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21659208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice