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General NPI Number Information
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NPI Number | 1992767768
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Entity Type | Individual
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Provider Name | GABRIEL RODRIGUEZ QUIJANO O.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | ROAD. #2 KM. 96.8 BO. COCOS
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City | QUEBADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 787-895-6197
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2272
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City | ISABELA
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State | PR
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Zip | 00662-2003
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Country | US
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Telephone | 787-895-6197
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 169
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License Number State | PR
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