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General NPI Number Information
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NPI Number | 1093701997
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Entity Type | Individual
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Provider Name | RAYMOND RODRIGUEZ III O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 766 CELEBRATION AVE UNIT 2203
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City | CELEBRATION
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State | FL
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Zip | 34747-5480
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Country | US
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Telephone | 787-462-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GRAND PASEO BLVD STE 116
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City | SAN JUAN
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State | PR
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Zip | 00926-6535
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Country | US
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Telephone | 787-755-1414
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Fax | 787-761-4141
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4377
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 228
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License Number State | PR
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