1427785195 NPI number — DR. JOSE GERARDO RODRIGUEZ VALENTIN MD

Table of content: DR. JOSE GERARDO RODRIGUEZ VALENTIN MD (NPI 1427785195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427785195 NPI number — DR. JOSE GERARDO RODRIGUEZ VALENTIN MD

Organization/Personal Information

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

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:
1427785195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1126
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623-1126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-313-1630
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
312 ST KM 1.5 INT
Provider Second Line Business Practice Location Address:
LAS MAGAS, MONTE GRANDE
Provider Business Practice Location Address City Name:
CABO ROJO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623-0062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-313-1630
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2022

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: 208D00000X , with the licence number:  022939 , 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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