MEDICARE: JOSE R 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	174400000X	Specialist

General Provider Information

NPI Number	:	1942241427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE R RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	EDIFICIO BETANCOURT 305
Second Line	:	ESQUINA PAVIA FERNANDEZ JUNCOS AVE
City	:	SANTURCE
State	:	PR
Zip	:	00910-0000
Country	:	US
Telephone Number	:	787-268-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	EDIFICIO BETANCOURT 305
Second Line	:	ESQUINA PAVIA FERNANDEZ JUNCOS AVE
City	:	SANTURCE
State	:	PR
Zip	:	00909-0000
Country	:	US
Telephone Number	:	787-268-1100
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/04/2022

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