Provider Demographics
NPI:1720286313
Name:RODRIGUEZ ROSARIO, SANDRA RAQUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:RAQUEL
Last Name:RODRIGUEZ ROSARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:235 STREET LLUVIA DE CORAL
Mailing Address - Street 2:URB,HACIENDA REAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-473-5510
Mailing Address - Fax:
Practice Address - Street 1:48 CALLE ORQUIDEA
Practice Address - Street 2:URB LOIZA VALLEY
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3596
Practice Address - Country:US
Practice Address - Phone:787-256-0848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11999208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice