MEDICARE: VICTOR ANDRES RODRIGUEZ RAPALE

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	208600000X	Surgery Physician	21452	PR
2	208C00000X	Colon & Rectal Surgery Physician	21452	PR

General Provider Information

NPI Number	:	1730599895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR ANDRES RODRIGUEZ RAPALE

Provider Business Mailing Address
First Line	:	PO BOX 2528
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00970-2528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 AVE FD ROOSEVELT STE 202
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2129
Country	:	US
Telephone Number	:	787-724-9595
Fax Number	:	787-724-9696

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

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	03/24/2021

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