Provider Demographics
NPI:1639198088
Name:RODRIGUEZ MIRANDA, HECTOR ADALID (RPT)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:ADALID
Last Name:RODRIGUEZ MIRANDA
Suffix:
Gender:M
Credentials:RPT
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 101
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0101
Mailing Address - Country:US
Mailing Address - Phone:787-894-3987
Mailing Address - Fax:787-814-1105
Practice Address - Street 1:44 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2878
Practice Address - Country:US
Practice Address - Phone:787-894-3987
Practice Address - Fax:787-680-0199
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR04360OtherAMERICAN HEALTH, INC
6410021OtherHUMANA
PR9000598OtherLA CRUZ AZUL DE PR
660547741OtherCIGNA
PR3303144OtherACCA
2931-5OtherPROSSAM
PR89205OtherTRIPLE-S
PR9000598OtherLA CRUZ AZUL DE PR