Provider Demographics
NPI:1992944334
Name:RODRIGUEZ MEDINA, HECTOR JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:JOSE
Last Name:RODRIGUEZ MEDINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HECTOR
Other - Middle Name:JOSE
Other - Last Name:RODRIGUEZ MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1277
Mailing Address - Street 2:GURABO COMMUNITY HEALTH CENTER
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-1277
Mailing Address - Country:US
Mailing Address - Phone:787-737-2311
Mailing Address - Fax:787-737-2377
Practice Address - Street 1:CARR. 941 SALIDA BO. JAGUAS
Practice Address - Street 2:GURABO COMMUNITY HEALTH CENTER
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-737-2311
Practice Address - Fax:787-737-2377
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine