Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0354 | PR |
NPI | 1326116336 |
---|---|
Provider Name | Dr. Ruben Benjamin Rodriguez |
First Address | Manati, PR 00674-1933 |
Second Address | Manati, PR 00674-4615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 19/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U91424 | (02) | PR |