Provider Demographics
NPI:1699336214
Name:RODRIGUEZ ALZUGARAY, GIPSIE (MD)
Entity type:Individual
Prefix:
First Name:GIPSIE
Middle Name:
Last Name:RODRIGUEZ ALZUGARAY
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 1:1107 CALLE 1 VILLA NEVAREZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-975-7977
Mailing Address - Fax:
Practice Address - Street 1:1 VILLA NEVAREZ
Practice Address - Street 2:1107
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5134
Practice Address - Country:US
Practice Address - Phone:787-975-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21418207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine