Provider Demographics
NPI:1841295920
Name:RODRIGUEZ SANCHEZ, RAFAEL E
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:E
Last Name:RODRIGUEZ SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 URB ALTAMONTE
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2662
Mailing Address - Country:US
Mailing Address - Phone:787-262-2246
Mailing Address - Fax:
Practice Address - Street 1:CALLE DE DIEGO 62-E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-5620
Practice Address - Fax:787-265-0085
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist