MEDICARE: MR. GIL A RODRIGUEZ RPH

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	183500000X	Pharmacist	5048	PR

General Provider Information

NPI Number	:	1932494705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GIL A RODRIGUEZ RPH

Provider Business Mailing Address
First Line	:	PR 190 & CAMPO RICO
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00979
Country	:	US
Telephone Number	:	787-762-1290
Fax Number	:	787-750-7144

Provider Business Practice Location Address
First Line	:	PR 190 & CAMPO RICO ST.
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00979-0000
Country	:	US
Telephone Number	:	787-762-1290
Fax Number	:

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

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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