Provider Demographics
NPI:1336344522
Name:RODRIGUEZ ALVAREZ, YESENIA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:MARIA
Last Name:RODRIGUEZ ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YESENIA
Other - Middle Name:
Other - Last Name:ALCALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:URB SABANERA 267 CAMINO DEL GUAYACAN
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-3608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MMC PROFESSIONAL PLAZA SUITE 407
Practice Address - Street 2:200 CALLE HERNANDEZ CARRION
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4689
Practice Address - Country:US
Practice Address - Phone:612-406-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58443207XS0106X, 207XS0106X
MN58442207X00000X
PR18200207X00000X, 207XS0106X
PR11433I207X00000X
PR26397R207X00000X
PR26847R207X00000X
PR27402R207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400178083Medicare PIN