Provider Demographics
NPI:1992744098
Name:RODRIGUEZ, MARIA L (MD)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:64 CALLE SANTA CRUZ
Mailing Address - Street 2:STE 208 GALERIA MEDICA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7004
Mailing Address - Country:US
Mailing Address - Phone:787-269-1022
Mailing Address - Fax:787-269-1077
Practice Address - Street 1:64 CALLE SANTA CRUZ
Practice Address - Street 2:STE 208 GALERIA MEDICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7004
Practice Address - Country:US
Practice Address - Phone:787-269-1022
Practice Address - Fax:787-269-1077
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2016-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR11114174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG40990Medicare UPIN