Individual
IVAN S RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 CALLE MATTEI LLUBERAS, YAUCO, PR 00698-3635
(787) 856-3380
(787) 856-3380
Mailing address
PO BOX 1418, LAJAS, PR 00667-1418
(787) 808-2247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5659
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24682
TRIPLE S INC
PR
Enumeration date
06/23/2006
Last updated
05/14/2020
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