# GRUPO FISIATRICO-DENTAL DEL ESTE, CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265874689
- **Authorized official:** DR. RICARDO A RODRIGUEZ MD (PRESIDENT)
- **Authorized official phone:** (787) 887-1110

## Contact information

- **Practice address:** JARDINES DE RIO GRANDE, CALLE 54 BG-176, RIO GRANDE, PR 00745
- **Practice address phone:** (787) 887-1110
- **Practice address fax:** (787) 888-7008
- **Mailing address:** SAN FRANCISCO, 225 CALLE VIOLETA, SAN JUAN, PR 00927-6223
- **Mailing address phone:** (787) 887-1110
- **Mailing address fax:** (787) 888-7008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1780 | PR | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 10386 | PR | Yes |

## Other

- **Enumeration date:** 07/26/2013
- **Last updated:** 06/02/2015