MEDICARE: DR. VICTOR MANUEL RODRIGUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146D00000X	Personal Emergency Response Attendant	5660	PR

General Provider Information

NPI Number	:	1285632885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR MANUEL RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	LA SIERRA DEL RIO BOX 115
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-292-4059
Fax Number	:	787-292-4059

Provider Business Practice Location Address
First Line	:	LA SIERRA DEL RIO 115
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-0115
Country	:	US
Telephone Number	:	787-292-4059
Fax Number	:	787-292-4059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	11/27/2012

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