1790862936 NPI number — MRS. LUZ E RODRIGUEZ-GONZALEZ MT

Table of content: DR. CLARE ELIZABETH ANDERSON MD (NPI 1669122206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790862936 NPI number — MRS. LUZ E RODRIGUEZ-GONZALEZ MT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ-GONZALEZ
Provider First Name:
LUZ
Provider Middle Name:
E
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MT
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:
1790862936
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:
AVE LOMAS VERDES 1C 14B
Provider Second Line Business Mailing Address:
PMB 168
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-798-4747
Provider Business Mailing Address Fax Number:
787-740-8395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROAD 174 KM 5 8
Provider Second Line Business Practice Location Address:
BARRIO GUARAGUAO
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-798-4747
Provider Business Practice Location Address Fax Number:
787-740-8395
Provider Enumeration Date:
11/01/2006

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: 246RM2200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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