1912076761 NPI number — WILFREDO RODRIGUEZ ARBOLEDA M.D.

Table of content: MRS. TIFFANY ELIZABETH LIBBY MSN, APN, CEN, FNP-C (NPI 1538604988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912076761 NPI number — WILFREDO RODRIGUEZ ARBOLEDA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ ARBOLEDA
Provider First Name:
WILFREDO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1912076761
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1971 CALLE SANDALO
Provider Second Line Business Mailing Address:
SAN RAMON
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-3940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-230-1625
Provider Business Mailing Address Fax Number:
787-230-1624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
C2 AVE ALEJANDRINO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969-4704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-230-1625
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006

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: 208100000X , with the licence number:  11557 , 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)