Provider Demographics
NPI:1104787100
Name:RODRIGUEZ CORTES, RAMON LUIS SR
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:LUIS
Last Name:RODRIGUEZ CORTES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3B22 CALLE DALMACIA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-7021
Mailing Address - Country:US
Mailing Address - Phone:939-490-4561
Mailing Address - Fax:
Practice Address - Street 1:3B22 CALLE DALMACIA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-7021
Practice Address - Country:US
Practice Address - Phone:939-490-4561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6643975171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications