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Organization
GEORGE L. RODRIGUEZ, M.D., P.C.
Active
Organization
GEORGE L. RODRIGUEZ, M.D., P.C.
Active
Other names
University Dynamic MRI
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN C. BAMBA (ADMINISTRATIVE DIRECTOR)
(215) 425-1500
Entity
Organization
Contact information
Practice address
841 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2401
(215) 425-1500
(215) 425-1659
Mailing address
841 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2401
(215) 425-1500
(215) 425-1659
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045575900
INDEPENDENCE BLUE CROSS/PERSONAL CHOICE
PA
Enumeration date
05/15/2007
Last updated
06/25/2008
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