MEDICARE: DR. VIRGEN MILAGROS RODRIGUEZ PEREZ 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	207Q00000X	Family Medicine Physician	ME126089	FL
2	207Q00000X	Family Medicine Physician	8730	PR
3	207Q00000X	Family Medicine Physician	Q9015	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	362671503	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1356342059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGEN MILAGROS RODRIGUEZ PEREZ M.D.

Provider Business Mailing Address
First Line	:	5788 ECKHERT RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3900
Country	:	US
Telephone Number	:	210-699-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	25723 OLD FREDERICKSBURG ROAD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78015
Country	:	US
Telephone Number	:	210-450-6800
Fax Number	:	210-450-6801

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	03/28/2022

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