Provider Demographics
NPI:1801883046
Name:RODRIGUEZ VELEZ, ROBERTO (MD)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:RODRIGUEZ VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CALLE TIVOLI
Mailing Address - Street 2:PASEO DEL PARQUE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6500
Mailing Address - Country:US
Mailing Address - Phone:787-748-8729
Mailing Address - Fax:787-760-2021
Practice Address - Street 1:100 AVE LOS VETERANOS
Practice Address - Street 2:HOSPITAL SANTA ROSA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-5714
Practice Address - Country:US
Practice Address - Phone:787-864-0101
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10262174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF29960Medicare UPIN
PR0083220Medicare ID - Type Unspecified