Provider Demographics
NPI:1720492978
Name:NRT FAMILY MEDICINE PSC
Entity Type:Organization
Organization Name:NRT FAMILY MEDICINE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-840-9708
Mailing Address - Street 1:CALLE MANUEL CHELO ROMAN #48
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-2217
Mailing Address - Country:US
Mailing Address - Phone:787-840-9708
Mailing Address - Fax:787-840-9708
Practice Address - Street 1:AVENIDA EDUARDO RUBERTE
Practice Address - Street 2:COLISEO SHOPPING CENTER SUITE 103
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1712
Practice Address - Country:US
Practice Address - Phone:787-840-9708
Practice Address - Fax:787-840-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty