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NPI 1780623009

NPI 1780623009 : MR. ANTONIO RODRIGUEZ : QUEBRADILLAS, PR

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General NPI Number Information
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    NPI Number           |    1780623009
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    Entity Type          |    Individual 
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    Provider Name        |    MR. ANTONIO RODRIGUEZ
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/05/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    BARRIO COCOS SECTOR PARCELAS
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    City                 |    QUEBRADILLAS
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    State                |    PR
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    Zip                  |    00678
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    Country              |    US
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    Telephone            |    787-895-7067
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    Fax                  |    787-895-7067
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Provider Business Mailing Address
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    Address Line         |    HC 2 BOX 8042 
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    City                 |    QUEBRADILLAS
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    State                |    PR
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    Zip                  |    00678-9802
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    Country              |    US
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    Telephone            |    787-895-7067
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    Fax                  |    787-895-7067
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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        |    3416L0300X
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    Taxonomy Name        |    Land Ambulance
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    License Number       |    P00904
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    License Number State |    PR
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