Provider Demographics
NPI:1902092562
Name:RODRIGUEZ, JOSUE MANUEL (PT DPT MCMT)
Entity type:Individual
Prefix:DR
First Name:JOSUE
Middle Name:MANUEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT DPT MCMT
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Other - First Name:
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Mailing Address - Street 1:J18 CALLE 6
Mailing Address - Street 2:URB VILLA RITA
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2104
Mailing Address - Country:US
Mailing Address - Phone:939-292-7022
Mailing Address - Fax:787-896-6721
Practice Address - Street 1:J18 CALLE 6
Practice Address - Street 2:URB VILLA RITA
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2104
Practice Address - Country:US
Practice Address - Phone:939-292-7022
Practice Address - Fax:787-896-6721
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30149225100000X
PR1445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist