MEDICARE: DR. ROLANDO ERNESTO RODRIGUEZ DIAZ MD

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	208D00000X	General Practice Physician	24401	PR

General Provider Information

NPI Number	:	1467271072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROLANDO ERNESTO RODRIGUEZ DIAZ MD

Provider Business Mailing Address
First Line	:	2621 BLVD LUIS A FERRE
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717-2106
Country	:	US
Telephone Number	:	939-438-4757
Fax Number	:

Provider Business Practice Location Address
First Line	:	2621 BLVD LUIS A FERRE
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717-2106
Country	:	US
Telephone Number	:	939-438-4757
Fax Number	:

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

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	06/27/2025

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