Provider Demographics
NPI:1932185345
Name:RODRIGUEZ FRONTERA, JOSE GERMAN SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GERMAN
Last Name:RODRIGUEZ FRONTERA
Suffix:SR
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 1:173 LUIS MUNOZ RIVERA ST.
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-0981
Mailing Address - Country:US
Mailing Address - Phone:787-736-4117
Mailing Address - Fax:787-736-2499
Practice Address - Street 1:173 LUIS MUNOZ RIVERA AVE..
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-736-4117
Practice Address - Fax:787-736-2499
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8098208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE66465Medicare UPIN
PR29374Medicare ID - Type UnspecifiedG. P.