MEDICARE: DR. REINALDO RODRIGUEZ 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	208600000X	Surgery Physician	10667	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	66-0558248	OTHER	PR	FEDERAL TAX ID

General Provider Information

NPI Number	:	1376508754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REINALDO RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	609 AVE TITO CASTRO
Second Line	:	SUITE 102 PMB 150
City	:	PONCE
State	:	PR
Zip	:	00716-0200
Country	:	US
Telephone Number	:	787-284-3616
Fax Number	:

Provider Business Practice Location Address
First Line	:	2431 BLVD LUIS A FERRE STE 306
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717-2116
Country	:	US
Telephone Number	:	787-284-3616
Fax Number	:	787-651-6288

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/11/2024

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Directions to “ DR. REINALDO RODRIGUEZ M.D.” Practice Location

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