Provider Demographics
NPI:1336914936
Name:RODRIGUEZ SARRAGA, GABRIEL ALEJANDRO
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ALEJANDRO
Last Name:RODRIGUEZ SARRAGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-04 BOX 43042
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:787-201-7895
Mailing Address - Fax:
Practice Address - Street 1:AVE. HOSTOS 410, CARR. #2
Practice Address - Street 2:BO. SABALOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-201-7895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program