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General NPI Number Information
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NPI Number | 1750205449
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Entity Type | Individual
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Provider Name | JORGE A RODRIGUEZ LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 9 CALLE IGUALDAD
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-863-1880
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Fax | 787-860-6464
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Provider Business Mailing Address
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Address Line | 412 CALLE FLAMBOYAN
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City | HUMACAO
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State | PR
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Zip | 00791-4907
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Country | US
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Telephone | 787-396-8233
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Fax |
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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 | 008674
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License Number State | PR
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