Provider Demographics
NPI:1255532529
Name:RODRIGUEZ ARCHILLA, JOSE ANGEL (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANGEL
Last Name:RODRIGUEZ ARCHILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SENDEROS EN MONTEHIEDRA
Mailing Address - Street 2:CALLE MALAQUITA, #31
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-208-2366
Mailing Address - Fax:
Practice Address - Street 1:126 AVE DE DIEGO
Practice Address - Street 2:SEIN MEDICAL PLAZA, SUITE 202
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3036
Practice Address - Country:US
Practice Address - Phone:787-208-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR16252208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation