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General NPI Number Information
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NPI Number | 1649256736
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Entity Type | Individual
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Provider Name | GLORIA A RODRIGUEZ MD, CEC, FACE
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Gender | Female
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 33 CALLE MAYAGUEZ PEREZ MORRIS
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City | SAN JUAN
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State | PR
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Zip | 00917-4917
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Country | US
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Telephone | 787-753-6938
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Fax | 787-993-1764
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Provider Business Mailing Address
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Address Line | 477 CALLE ALVERIO LA MERCED
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City | SAN JUAN
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State | PR
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Zip | 00918-2620
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Country | US
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Telephone | 787-764-1103
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Fax | 787-764-1103
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 6380
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License Number State | PR
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