Provider Demographics
NPI:1467490227
Name:OJEDA RODRIGUEZ, AILEEN (MD)
Entity type:Individual
Prefix:DR
First Name:AILEEN
Middle Name:
Last Name:OJEDA RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND BLVD PASEOS
Mailing Address - Street 2:SUITE 112 MSC 440
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5955
Mailing Address - Country:US
Mailing Address - Phone:787-283-1554
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND BLVD PASEOS
Practice Address - Street 2:SUITE 112 MSC 440
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5955
Practice Address - Country:US
Practice Address - Phone:787-283-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13158208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020707Medicare PIN
PRH42129Medicare UPIN