Healthcare Provider Details

I. General information

NPI: 1427072735
Provider Name (Legal Business Name): PABLO RODRIGUEZ-ORTIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO DE TRAUMA - ASEM CENTRO MEDICO DE PR
RIO PIEDRAS PR
00935
US

IV. Provider business mailing address

CIRUGIA TRAUMA RCM PO BOX 29134
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3760
  • Fax: 787-777-3781
Mailing address:
  • Phone: 787-777-3760
  • Fax: 787-777-3781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9076
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number9076
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number9076
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: