Organization
RENOVA CORP. CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANICE MARIE RODRIGUEZ MD (MEDICAL DIRECTOR)
(787) 412-7009
Entity
Organization
Contact information
Practice address
CARR 2 KM 141.1 AVE SEVEREANO CUEVAS #18, WESTERN MEDICAL PLAZA 1ST FLOOR SUITE # 24, AGUADILLA, PR 00605
(787) 412-7009
(787) 919-0644
Mailing address
CARR 2 KM 141.1 AVE SEVEREANO CUEVAS #18, WESTERN MEDICAL PLAZA 1ST FLOOR SUITE 24 AGUADILLA, AGUADILLA, PR 00605
(787) 412-7009
(787) 919-0644
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
17029
PR
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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