Individual
DR. AGUSTIN ANTONIO RODRIGUEZ GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1056 AVE MUNOZ RIVERA, FIRSTBANK, SUITE 403, RIO PIEDRAS, PR 00927-5015
(787) 765-1630
(787) 756-6957
Mailing address
PO BOX 364683, SAN JUAN, PR 00936-4683
(787) 756-8562
(787) 763-3898
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
11986
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088623
MEDICARE PTAN
PR
Enumeration date
02/22/2006
Last updated
07/21/2011
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