Provider Demographics
NPI:1154523868
Name:CIRINO RODRIGUEZ, JUAN J
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:J
Last Name:CIRINO RODRIGUEZ
Suffix:
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:STREET 5 C34
Mailing Address - Street 2:FLAMBOYAN GARDENS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-203-3207
Mailing Address - Fax:787-765-2423
Practice Address - Street 1:STREET 5 C34
Practice Address - Street 2:FLAMBOYAN GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-203-3207
Practice Address - Fax:787-765-2423
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15259208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15259OtherLICENSE
PR15259OtherLICENSE