Healthcare Provider Details

I. General information

NPI: 1588041263
Provider Name (Legal Business Name): MANUEL ALEXIS RODRIGUEZ PEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 07/06/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL SAN FRANCISCO TORRE MEDICA OFICINA 209 371 DE DIEGO
SAN JUAN PR
00923
US

IV. Provider business mailing address

191 CALLE CESAR GONZALEZ APT 1204
SAN JUAN PR
00918-1430
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-5100
  • Fax: 787-250-7829
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number21810
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: