Provider Demographics
NPI:1831169390
Name:RODRIGUEZ, RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:RODRIGUEZ
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 1:1742 CALLE MARQUESA
Mailing Address - Street 2:VALLE REAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0505
Mailing Address - Country:US
Mailing Address - Phone:787-848-4397
Mailing Address - Fax:787-742-0176
Practice Address - Street 1:1742 CALLE MARQUESA
Practice Address - Street 2:VALLE REAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0505
Practice Address - Country:US
Practice Address - Phone:787-848-4397
Practice Address - Fax:787-742-0176
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6515146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0677086OtherDRIVER LICENCE