Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 19914 | PR |
N | 207L00000X | Anesthesiologist | 19914 | PR |
N | 207N00000X | Dermatologist | 19914 | PR |
N | 207P00000X | Emergency Physician | 19914 | PR |
N | 207Q00000X | Family Doctor | 19914 | PR |
N | 207R00000X | Internist | 19914 | PR |
N | 111NI0900X | Internist | 19914 | PR |
N | 207V00000X | Obstetrician & Gynecologist | 19914 | PR |
N | 207X00000X | Orthopaedic Surgeon | 19914 | PR |
N | 208000000X | Pediatrician | 19914 | PR |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 19914 | PR |
N | 208200000X | Surgeon | 19914 | PR |
N | 208600000X | Surgeon | 19914 | PR |
N | 208200000X | Surgeon | 19914 | PR |
N | 208600000X | Surgeon | 19914 | PR |
N | 208800000X | Urologist | 19914 | PR |
Y | 208D00000X | General Practice Physician | 19914 | PR |
NPI | 1164814034 |
---|---|
Provider Name | Jim Rodriguez |
First Address | Juana Diaz, PR 00795 |
Second Address | Juana Diaz, PR 00795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2015 |
Last Update Date | 02/03/2015 |