Provider Demographics
NPI:1932494705
Name:RODRIGUEZ, GIL A (RPH)
Entity Type:Individual
Prefix:MR
First Name:GIL
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PR 190 & CAMPO RICO
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-762-1290
Mailing Address - Fax:787-750-7144
Practice Address - Street 1:PR 190 & CAMPO RICO ST.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-0000
Practice Address - Country:US
Practice Address - Phone:787-762-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist