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NPI Code Detail

MEDICARE: LUIS M. RODRIGUEZ-MORA M.D.

MEDICARE: LUIS M. RODRIGUEZ-MORA 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
1207RC0000XCardiovascular Disease Physician4282PR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2991211OTHERPRMEDICARE Y MUCHO MAS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15774OTHERPRINTERNATIONAL MEDICAL CAR
3063758OTHERPRCRUZ AZUL DE PUERTO RICO
495413OTHERPRTRIPLE-S

General Provider Information

NPI Number : 1942285101
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS M. RODRIGUEZ-MORA M.D.
Provider Business Mailing Address
First Line : PO BOX 597
Second Line :
City : ARECIBO
State : PR
Zip : 00613-0597
Country : US
Telephone Number : 787-878-4800
Fax Number : 787-817-1237
Provider Business Practice Location Address
First Line : 55 CALLE PALMA
Second Line : SUSONI MEDICAL BUILDING, SUITE 101
City : ARECIBO
State : PR
Zip : 00612-4526
Country : US
Telephone Number : 787-878-4800
Fax Number : 787-817-1237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 07/08/2007

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