Provider Demographics
NPI:1912186222
Name:RODRIGUEZ, JOSE ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:AVE ALEJANDRINO
Mailing Address - Street 2:COND, FONTAINEBLEU PLAZA, APT. 1104
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7003
Mailing Address - Country:US
Mailing Address - Phone:787-287-4510
Mailing Address - Fax:787-287-4510
Practice Address - Street 1:AVE ALEJANDRINO
Practice Address - Street 2:COND, FONTAINEBLEU PLAZA, APT. 1104
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-7003
Practice Address - Country:US
Practice Address - Phone:787-287-4510
Practice Address - Fax:787-287-4510
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR5860208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice