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Individual

DR. RAFAEL RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
PMB SUITE 145, AVE. 90 RIO HONDO, BAYAMON, PR 00961-3113
(787) 378-1040
Mailing address
110 ESMERALDA, CIELO DORADO VILLAGE, VEGA ALTA, PR 00692
(787) 270-1506
(787) 870-1508

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
08088
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08088
STATE MEDICAL LICENSE
PR
01
2-8088
MCS
PR
01
203302
PREFFERED HEALTH
PR
01
7232
INTERNATIAL MEDICAL CARD
PR
01
7830002
HUMANA INSURANCE
PR
01
82919-RO
TRIPLE-S
PR
01
M-1915
CRUZ AZUL
PR
Enumeration date
11/22/2006
Last updated
07/08/2007
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