Provider Demographics
NPI:1124454780
Name:AIXA RODRIGUEZ REGENERATIVE MEDICINE & INFUSION CENTER
Entity type:Organization
Organization Name:AIXA RODRIGUEZ REGENERATIVE MEDICINE & INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AIXA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-884-8071
Mailing Address - Street 1:17 CALLE LAS PALMAS
Mailing Address - Street 2:PASEO DE DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2041
Mailing Address - Country:US
Mailing Address - Phone:787-884-8071
Mailing Address - Fax:
Practice Address - Street 1:17 CALLE LAS PALMAS
Practice Address - Street 2:PASEO DE DORADO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-2041
Practice Address - Country:US
Practice Address - Phone:787-884-8071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10800207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty