1881658961 NPI number — HECTOR C. RODRIGUEZ-PHIPPS MD

Table of content: HECTOR C. RODRIGUEZ-PHIPPS MD (NPI 1881658961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881658961 NPI number — HECTOR C. RODRIGUEZ-PHIPPS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ-PHIPPS
Provider First Name:
HECTOR
Provider Middle Name:
C.
Provider Name Prefix Text:
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:
1881658961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 CALLE CALDERON MUJICA
Provider Second Line Business Mailing Address:
BO PUEBLO
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00729-3127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-376-1606
Provider Business Mailing Address Fax Number:
787-256-2054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 CALLE CALDERON MUJICA
Provider Second Line Business Practice Location Address:
BO PUEBLO
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00729-3127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-256-2045
Provider Business Practice Location Address Fax Number:
787-256-2054
Provider Enumeration Date:
04/14/2006

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: 174400000X , with the licence number:  11582 , 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)

  • Identifier: IQ509A . This is a "PTAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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