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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