MEDICARE: DR. JUAN 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	208000000X	Pediatrics Physician	6715	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649243163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 801220
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-1220
Country	:	US
Telephone Number	:	787-837-4000
Fax Number	:	787-837-4000

Provider Business Practice Location Address
First Line	:	7 CALLE LA CRUZ
Second Line	:
City	:	JUANA DIAZ
State	:	PR
Zip	:	00795-2426
Country	:	US
Telephone Number	:	787-837-4000
Fax Number	:	787-837-4000

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	07/13/2015

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

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