Provider Demographics
NPI:1922591874
Name:RODRIGUEZ CLARAMUNT, JOSE ALFONSO
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALFONSO
Last Name:RODRIGUEZ CLARAMUNT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 S FREMONT AVE STE 3050
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2236
Mailing Address - Country:US
Mailing Address - Phone:417-820-5200
Mailing Address - Fax:
Practice Address - Street 1:2115 S FREMONT AVE STE 3050
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2236
Practice Address - Country:US
Practice Address - Phone:417-820-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2023008501207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program