Provider Demographics
NPI:1659184802
Name:RODRIGUEZ ALBA, ANGEL RICARDO (BSN)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:RICARDO
Last Name:RODRIGUEZ ALBA
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:MR
Other - First Name:ANGEL
Other - Middle Name:RICARDO
Other - Last Name:RODRIGUEZ ALBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN
Mailing Address - Street 1:44 CAMINO LOS CRUCE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9520
Mailing Address - Country:US
Mailing Address - Phone:787-226-3522
Mailing Address - Fax:
Practice Address - Street 1:901 CALLE SORBONA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4807
Practice Address - Country:US
Practice Address - Phone:787-226-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR93511G163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty