1265487490 NPI number — DR. ZOE M. RODRIGUEZ MD

Table of content: DR. ZOE M. RODRIGUEZ MD (NPI 1265487490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265487490 NPI number — DR. ZOE M. RODRIGUEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ
Provider First Name:
ZOE
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265487490
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 140430
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00614-0430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-756-4010
Provider Business Mailing Address Fax Number:
787-817-1502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DEPARTMENT OF PEDIATRICS UPR SCHOOL OF MEDICINE
Provider Second Line Business Practice Location Address:
FIRST FLOOR, OFFICE A1-29 UNIVERSITY PEDIATRIC HOSPITAL
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-756-4020
Provider Business Practice Location Address Fax Number:
787-777-3227
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0208X , with the licence number:  12,680 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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