MEDICARE: DR. RODRIGO JUAN VALDERRABANO M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME131579	FL
2	207R00000X	Internal Medicine Physician	18254	PR

General Provider Information

NPI Number	:	1184805186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODRIGO JUAN VALDERRABANO M.D.

Provider Business Mailing Address
First Line	:	111 GROSSMAN DR
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-4997
Country	:	US
Telephone Number	:	617-657-6430
Fax Number	:	781-849-2274

Provider Business Practice Location Address
First Line	:	111 GROSSMAN DR
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-4997
Country	:	US
Telephone Number	:	617-657-6430
Fax Number	:	781-849-2274

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

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	03/28/2026

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