Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 12382 | PR |
NPI | 1003815879 |
---|---|
Provider Name | Dr. Raul A Rodriguez Almodovar |
First Address | Vega Baja, PR 00694-0132 |
Second Address | Vega Baja, PR 00693-4469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82130 | (02) | PR |