Healthcare Provider Details

I. General information

NPI: 1033986930
Provider Name (Legal Business Name): CARLOS ALBERTO RODRIGUEZ ECHEVARRIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 129 KM 1.0 AVENIDA SAN LUIS
ARECIBO PR
00613
US

IV. Provider business mailing address

PO BOX 1200
PENUELAS PR
00624-1200
US

V. Phone/Fax

Practice location:
  • Phone: 787-533-4458
  • Fax:
Mailing address:
  • Phone: 787-533-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24473
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36919R
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: