=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255809067
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMONPSC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2018
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | V3-46 CALLE SANDALIO ALONSO
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00921-3609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-706-0981
-----------------------------------------------------
Fax | 754-218-0816
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | URB LAS PALMAS DE CERRO GORDO CALLE ALEXANDRA 131
-----------------------------------------------------
City | VEGA ALTA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-223-2795
-----------------------------------------------------
Fax | 787-858-0818
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL PHYSICIAN
-----------------------------------------------------
Name | DR. JAIME GABRIEL RODRIGUEZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 787-706-0981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------