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General NPI Number Information
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NPI Number | 1598627697
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Entity Type | Organization
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Legal Business Name | PUERTO RICO ORTHOPEDIC SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 519
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City | SAN JUAN
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State | PR
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Zip | 00917-5028
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Country | US
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Telephone | 787-772-1007
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Fax |
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Provider Business Mailing Address
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Address Line | A18 CALLE PRINCIPE DE ASTURIAS
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City | GUAYNABO
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State | PR
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Zip | 00969-5261
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Country | US
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Telephone | 787-459-2407
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OMAR E RODRIGUEZ ALEJANDRO
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Credential | MD
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Telephone | 787-459-2407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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