MEDICARE: DR. MANUEL GONZALEZ-RODRIGUEZ 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	174400000X	Specialist	8908	PR
2	207RP1001X	Pulmonary Disease Physician	8908	PR

General Provider Information

NPI Number	:	1548257421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL GONZALEZ-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 8878
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00988-8878
Country	:	US
Telephone Number	:	787-378-6731
Fax Number	:	787-768-2722

Provider Business Practice Location Address
First Line	:	CARRETERA 3, KM. 8.3, AVE. 65 DE INFANTERIA
Second Line	:	HOSPITAL UPR DR. FEDERICO TRILLA
City	:	CAROLINA
State	:	PR
Zip	:	00984
Country	:	US
Telephone Number	:	787-757-1800
Fax Number	:	787-276-2205

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	10/06/2020

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