MEDICARE: MARIA DEL C ALVELO RODRIGUEZ DMDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1125	PR

General Provider Information

NPI Number	:	1073629242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DEL C ALVELO RODRIGUEZ DMDD

Provider Business Mailing Address
First Line	:	PO BOX 7402
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7402
Country	:	US
Telephone Number	:	787-842-4959
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 AVE EDUARDO RUBERTE
Second Line	:	SUITE 107 COLISEO SHOPPING CENTER
City	:	PONCE
State	:	PR
Zip	:	00728-1739
Country	:	US
Telephone Number	:	787-842-4959
Fax Number	:	787-842-4959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	08/22/2016

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