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General NPI Number Information
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NPI Number | 1649214776
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Entity Type | Organization
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Legal Business Name | DR.JESUS W RODRIGUEZ,PSC
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARRETERA 132 KM 22.1BO CANAS PLAZA GABRIELA
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City | PONCE
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State | PR
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Zip | 00728
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Country | US
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Telephone | 787-812-3939
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Fax | 787-812-3931
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Provider Business Mailing Address
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Address Line | PO BOX 664
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City | MERCEDITA
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State | PR
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Zip | 00715-0664
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Country | US
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Telephone | 787-812-3939
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Fax | 787-812-3931
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. JESUS W RODRIGUEZ
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Credential | M.D.
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Telephone | 787-812-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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