Provider Demographics
NPI:1205504693
Name:RODRIGUEZ, CRISTINA MARIE (MD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
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:HC 6 BOX 61284
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9058
Mailing Address - Country:US
Mailing Address - Phone:787-475-6847
Mailing Address - Fax:
Practice Address - Street 1:URB MONTE MAYOR CALLE CARPINTERO 605
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-0064
Practice Address - Country:US
Practice Address - Phone:787-475-6847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15830-I208D00000X
PR23005208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice