MEDICARE: DR. VICTOR M RODRIGUEZ VENEGAS 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	174400000X	Specialist	10821	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G41720	MEDICARE UPIN	PR

General Provider Information

NPI Number	:	1922084193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR M RODRIGUEZ VENEGAS MD

Provider Business Mailing Address
First Line	:	2431 AVE LAS AMERICAS
Second Line	:	A PORRATA PILA SUITE 204
City	:	PONCE
State	:	PR
Zip	:	00717-2116
Country	:	US
Telephone Number	:	787-847-4246
Fax Number	:

Provider Business Practice Location Address
First Line	:	2431 AVE LAS AMERICAS
Second Line	:	A PORRATA PILA SUITE 204
City	:	PONCE
State	:	PR
Zip	:	00717-2116
Country	:	US
Telephone Number	:	787-847-4246
Fax Number	:

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	12/11/2012

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Directions to “ DR. VICTOR M RODRIGUEZ VENEGAS MD” Practice Location

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