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General NPI Number Information
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NPI Number | 1528009099
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Entity Type | Individual
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Provider Name | JOSE ENRIQUE RODRIGUEZ-ROSA MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 1486 AVE EMERITO ESTRADA
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-3047
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Country | US
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Telephone | 787-926-0668
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Fax | 787-926-0668
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Provider Business Mailing Address
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Address Line | HC 56 BOX 4960
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City | AGUADA
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State | PR
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Zip | 00602-8668
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Country | US
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Telephone | 787-462-0691
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Fax | 787-926-0668
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 10108
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License Number State | PR
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