Provider Demographics
NPI:1881658961
Name:RODRIGUEZ-PHIPPS, HECTOR C (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:C
Last Name:RODRIGUEZ-PHIPPS
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 1:65 CALLE CALDERON MUJICA
Mailing Address - Street 2:BO PUEBLO
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-3127
Mailing Address - Country:US
Mailing Address - Phone:787-376-1606
Mailing Address - Fax:787-256-2054
Practice Address - Street 1:65 CALLE CALDERON MUJICA
Practice Address - Street 2:BO PUEBLO
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3127
Practice Address - Country:US
Practice Address - Phone:787-256-2045
Practice Address - Fax:787-256-2054
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11582174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRIQ509AOtherPTAN
PR20806ROMedicare UPIN