Provider Demographics
NPI:1336574649
Name:RECOVERY ANESTHESIA, LLC
Entity Type:Organization
Organization Name:RECOVERY ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE A
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-602-8949
Mailing Address - Street 1:1896 PETUNIA ST
Mailing Address - Street 2:URBANIZACION SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-602-8949
Mailing Address - Fax:
Practice Address - Street 1:89 AVENIDA DE DIEGO STE. 105
Practice Address - Street 2:PMB 721
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6346
Practice Address - Country:US
Practice Address - Phone:787-602-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13248207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty