Healthcare Provider Details

I. General information

NPI: 1811814320
Provider Name (Legal Business Name): VINCENT MANUEL BEY RODRIGUEZ MD, PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 AVE HOSTOS
PONCE PR
00716-1115
US

IV. Provider business mailing address

HC 10 BOX 8456
SABANA GRANDE PR
00637-9763
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-9393
  • Fax:
Mailing address:
  • Phone: 787-843-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number002611-PA
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: