Provider Demographics
NPI:1013307214
Name:DRA. MINERVA RODRIGUEZ-INFECTOLOGA, CSP
Entity Type:Organization
Organization Name:DRA. MINERVA RODRIGUEZ-INFECTOLOGA, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:N
Authorized Official - Last Name:RODRIGUEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-202-4081
Mailing Address - Street 1:PO BOX 1696
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1696
Mailing Address - Country:US
Mailing Address - Phone:939-202-4081
Mailing Address - Fax:
Practice Address - Street 1:77 CALLE ALTA MAR
Practice Address - Street 2:URB. LAS VISTAS
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-9401
Practice Address - Country:US
Practice Address - Phone:939-202-4081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16391207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty