Provider Demographics
NPI:1720016546
Name:MUNOZ- RODRIGUEZ, CHRISTINE M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:MUNOZ- 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:ROAD 506 KM 1 TORRE SAN CRISTOBAL
Mailing Address - Street 2:SUITE 312
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-842-1407
Mailing Address - Fax:787-842-1407
Practice Address - Street 1:ROAD 506 KM 1
Practice Address - Street 2:TORRE SAN CRISTOBAL SUITE 312
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-842-1407
Practice Address - Fax:787-842-1407
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14050174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022544OtherPTAN
PRI-16448Medicare UPIN