Provider Demographics
NPI:1457526758
Name:RODRIGUEZ APONTE, RICARDO (MD)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:RODRIGUEZ APONTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICARDO
Other - Middle Name:
Other - Last Name:RODRIGUEZ APONTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 675
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-0675
Mailing Address - Country:US
Mailing Address - Phone:787-735-0040
Mailing Address - Fax:787-735-0041
Practice Address - Street 1:111 CALLE JOSE C VAZQUEZ
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3301
Practice Address - Country:US
Practice Address - Phone:787-735-0040
Practice Address - Fax:787-735-0041
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17127207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFS092AMedicare PIN