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NPI Code Detail

MEDICARE: DR. JOSE R RODRIGUEZ-VEGA M.D.

MEDICARE: DR. JOSE R RODRIGUEZ-VEGA 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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician10930PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1601510OTHERPRPROVIDER NO.
2N739OTHERPRPROVIDER NO.
388498OTHERPRPROVIDER NO.
4204114OTHERPRPROVIDER NO.
59500060OTHERPRPROVIDER NO.

General Provider Information

NPI Number : 1316940570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE R RODRIGUEZ-VEGA M.D.
Provider Business Mailing Address
First Line : PO BOX 70344 PMB 26
Second Line :
City : SAN JUAN
State : PR
Zip : 00936-8344
Country : US
Telephone Number : 787-620-4763
Fax Number : 787-288-2301
Provider Business Practice Location Address
First Line : 70 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-7052
Country : US
Telephone Number : 787-620-4763
Fax Number : 787-288-2301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 02/07/2022

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