Healthcare Provider Details

I. General information

NPI: 1235114315
Provider Name (Legal Business Name): ORLANDO RODRIGUEZ MD, MMS, FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA ROOM C-281
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

PO BOX 33038
SAN JUAN PR
00933-3038
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-641-7582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number11988
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number11988
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: