Provider Demographics
NPI:1649570995
Name:JOSE I RODRIGUEZ-OSPINA MD PC
Entity type:Organization
Organization Name:JOSE I RODRIGUEZ-OSPINA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/M.D.
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:IGNACIO
Authorized Official - Last Name:RODRIGUEZ-OSPINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-205-4900
Mailing Address - Street 1:9319 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7943
Mailing Address - Country:US
Mailing Address - Phone:718-205-4900
Mailing Address - Fax:718-205-4909
Practice Address - Street 1:9319 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7943
Practice Address - Country:US
Practice Address - Phone:718-205-4900
Practice Address - Fax:718-205-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty