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General NPI Number Information
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NPI Number | 1871835504
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Entity Type | Organization
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Legal Business Name | DR. JUAN F. RODRIGUEZ ACOSTA, PSC
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | URB. EL MONTE 3659, CALLE CUMBRE
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 939-640-2163
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 PONCE BYP STE 904
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City | PONCE
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State | PR
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Zip | 00717-1381
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Country | US
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Telephone | 787-849-5300
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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. JUAN F RODRIGUEZ
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Credential | MD
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Telephone | 939-640-2163
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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 | 008238
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License Number State | PR
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