Provider Demographics
NPI:1427072735
Name:RODRIGUEZ-ORTIZ, PABLO (MD)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:
Last Name:RODRIGUEZ-ORTIZ
Suffix:
Gender:M
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:CIRUGIA TRAUMA RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-777-3760
Mailing Address - Fax:787-777-3781
Practice Address - Street 1:CENTRO DE TRAUMA - ASEM
Practice Address - Street 2:CENTRO MEDICO DE PR
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-777-3760
Practice Address - Fax:787-777-3781
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9076208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PREO9367Medicare UPIN