Healthcare Provider Details

I. General information

NPI: 1174271795
Provider Name (Legal Business Name): BIANCA CRISTINA RODRIGUEZ MARTINEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO DE PUERTO RICO CARRETERA 22, BARRIO MONACILLOS
SAN JUAN PR
00922
US

IV. Provider business mailing address

PO BOX 365067
SAN JUAN PR
00936-5067
US

V. Phone/Fax

Practice location:
  • Phone: 939-940-2011
  • Fax:
Mailing address:
  • Phone: 787-474-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24932
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: