Provider Demographics
NPI:1487765699
Name:RODRIGUEZ, MIGUEL EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:EDUARDO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CALLE MUNOZ RIVERA
Mailing Address - Street 2:C-2
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-2603
Mailing Address - Country:US
Mailing Address - Phone:787-746-6900
Mailing Address - Fax:787-745-4252
Practice Address - Street 1:2 CALLE MUNOZ RIVERA
Practice Address - Street 2:C-2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2603
Practice Address - Country:US
Practice Address - Phone:787-746-6900
Practice Address - Fax:787-745-4252
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07421207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR082238Medicare UPIN