MEDICARE: MIGUEL ANGEL 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	207R00000X	Internal Medicine Physician	14615	PR

General Provider Information

NPI Number	:	1568466522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL ANGEL RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 1777
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-1777
Country	:	US
Telephone Number	:	787-739-4444
Fax Number	:	787-739-3195

Provider Business Practice Location Address
First Line	:	CENTRO SALUD FAMILIAR HOSPITAL MENONITA
Second Line	:	AVENIDA EL JIBARO OTICINA 108
City	:	CIDRA
State	:	PR
Zip	:	00739
Country	:	US
Telephone Number	:	787-739-4444
Fax Number	:	787-739-3195

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/08/2007

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