Provider Demographics
NPI:1245331339
Name:RODRIGUEZ, JUAN A (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:90 CALLE REINA DE LAS FLORES
Mailing Address - Street 2:CIUDAD JARDIN 3
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4860
Mailing Address - Country:US
Mailing Address - Phone:787-785-4851
Mailing Address - Fax:787-785-4851
Practice Address - Street 1:CALLE 1 48 EXT. HERMANAS DAVILA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-4851
Practice Address - Fax:787-785-4851
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-11-22
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Provider Licenses
StateLicense IDTaxonomies
PR4369207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D95838Medicare UPIN