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General NPI Number Information
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NPI Number | 1407732373
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Entity Type | Individual
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Provider Name | ANGEL GUSTAVO RODRIGUEZ MATOS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 100 CALLE FLORENTINO ROMAN STE 120
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City | CAROLINA
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State | PR
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Zip | 00987-6703
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Country | US
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Telephone | 787-768-4366
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Fax | 787-768-4367
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Provider Business Mailing Address
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Address Line | PO BOX 29775
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City | SAN JUAN
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State | PR
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Zip | 00929-0775
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Country | US
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Telephone | 787-768-4366
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Fax | 787-768-4367
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8411
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License Number State | PR
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