Provider Demographics
NPI:1861440794
Name:RODRIGUEZ, REMY (MD)
Entity Type:Individual
Prefix:DR
First Name:REMY
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:CENTRO CARIBE SUITE 103
Mailing Address - Street 2:PONCE BY PASS 2053
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1307
Mailing Address - Country:US
Mailing Address - Phone:787-841-1730
Mailing Address - Fax:787-841-1725
Practice Address - Street 1:CENTRO CARIBE SUITE 103
Practice Address - Street 2:PONCE BY PASS 2053
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1307
Practice Address - Country:US
Practice Address - Phone:787-841-1730
Practice Address - Fax:787-841-1725
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR74652085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC83167Medicare UPIN