Provider Demographics
NPI:1730254582
Name:RODRIGUEZ UBARRI, JOSE ANTONIO SR (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:RODRIGUEZ UBARRI
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 29471
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0471
Mailing Address - Country:US
Mailing Address - Phone:787-757-7725
Mailing Address - Fax:787-757-7725
Practice Address - Street 1:237 SAN MARCOS AVE
Practice Address - Street 2:URB EL COMANDANTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-757-7725
Practice Address - Fax:787-757-7725
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5161208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26688OtherTRIPLE S
PR26688OtherTRIPLE S