MEDICARE: MARY ANN RODRIGUEZ JUARBE 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	207RC0000X	Cardiovascular Disease Physician	4490	PR

General Provider Information

NPI Number	:	1700841400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN RODRIGUEZ JUARBE MD

Provider Business Mailing Address
First Line	:	154 EBANO
Second Line	:	GOLDEN GATE
City	:	GUAYNABO
State	:	PR
Zip	:	00968
Country	:	US
Telephone Number	:	787-781-7561
Fax Number	:	787-273-1260

Provider Business Practice Location Address
First Line	:	1588 AVE JT PINERO
Second Line	:	CAPARRA TERRACE
City	:	SAN JUAN
State	:	PR
Zip	:	00921-1413
Country	:	US
Telephone Number	:	787-781-7561
Fax Number	:	787-273-1260

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/08/2007

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