Provider Demographics
NPI:1013914019
Name:RODRIGUEZ-SANTANA, JOSE RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAFAEL
Last Name:RODRIGUEZ-SANTANA
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:PO BOX 8129
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8129
Mailing Address - Country:US
Mailing Address - Phone:787-758-2780
Mailing Address - Fax:787-763-6171
Practice Address - Street 1:735 PONCE DE LEON AVE
Practice Address - Street 2:TORRE AUXILIO MUTUO SUITE 215
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-758-2780
Practice Address - Fax:787-763-6171
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR78222080P0214X, 2080P0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7822OtherMEDICAL LICENSE NUMBER
PR99605OtherTRIPLE S