Provider Demographics
NPI:1215422563
Name:SEDA RODRIGUEZ, LAURA PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PATRICIA
Last Name:SEDA RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8367
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8367
Mailing Address - Country:US
Mailing Address - Phone:787-242-1628
Mailing Address - Fax:
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:1845 CARR 2 STE 508
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7204
Practice Address - Country:US
Practice Address - Phone:787-798-5323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
PR22842207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program