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General NPI Number Information
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NPI Number | 1295843837
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Entity Type | Individual
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Provider Name | JOSUE BAUTISTA RODRIGUEZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 146 CALLE DEL PARQUE
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City | SAN JUAN
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State | PR
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Zip | 00911-1919
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Country | US
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Telephone | 787-722-5422
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Fax | 787-721-5869
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Provider Business Mailing Address
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Address Line | 1663 AVE PONCE DE LEON APT# 705
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City | SAN JUAN
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State | PR
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Zip | 00909-1851
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Country | US
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Telephone | 787-671-9555
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Fax | 787-721-5869
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 421
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License Number State | PR
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