MEDICARE: JOSE ALBERTO 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	207X00000X	Orthopaedic Surgery Physician	21258	PR

General Provider Information

NPI Number	:	1609134881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ALBERTO RODRIGUEZ DIAZ MD

Provider Business Mailing Address
First Line	:	710 CALLE UN APT 202
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00907-4238
Country	:	US
Telephone Number	:	787-955-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 CARR 696
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-5718
Country	:	US
Telephone Number	:	787-625-5050
Fax Number	:	787-625-1081

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

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	10/11/2022

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