Provider Demographics
NPI:1457392474
Name:RODRIGUEZ PEREZ, HECTOR (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:RODRIGUEZ PEREZ
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 1:420 AVE PONCE DE LEON
Mailing Address - Street 2:SUITE 603 EDIF MIDTOWN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3406
Mailing Address - Country:US
Mailing Address - Phone:787-753-0920
Mailing Address - Fax:787-281-8913
Practice Address - Street 1:420 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 603 EDIF MIDTOWN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3406
Practice Address - Country:US
Practice Address - Phone:787-753-0920
Practice Address - Fax:787-281-8913
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR42592084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR25529OtherTRIPLE S
PR063608OtherCRUZ AZUL
PR1525OtherMMM
PR1773OtherHUMANA
C79468Medicare UPIN
PR25529OtherTRIPLE S