Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 6245 | PR |
NPI | 1073505749 |
---|---|
Provider Name | Dr. Aristides J Rodriguez |
First Address | Guaynabo, PR 00969 |
Second Address | Guaynabo, PR 00969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 08/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E43304 | (02) | PR |