Healthcare Provider Details
I. General information
NPI: 1548451859
Provider Name (Legal Business Name): HARRY ALVERIO RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/05/2007
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
GO 5 AVE CAMPO RICO COUNTRY CLUB
CAROLINA PR
00982-2678
US
IV. Provider business mailing address
4K35 CALLE 214 COLINAS DE FAIR VIEW
TRUJILLO ALTO PR
00976-8247
US
V. Phone/Fax
- Phone: 787-762-3572
- Fax:
- Phone: 787-354-8726
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 17061 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: