Healthcare Provider Details

I. General information

NPI: 1407969215
Provider Name (Legal Business Name): JAN RODRIGUEZ FERRER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 CARR 844 SAN JUAN TOWER APTO 401
SAN JUAN PR
00926
US

IV. Provider business mailing address

CARR 844 COND SAN JUAN TOWER 1299 APTO 401
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-614-9285
  • Fax:
Mailing address:
  • Phone: 787-614-9285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12981
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: