Provider Demographics
NPI:1205805876
Name:RODRIGUEZ, MARIBEL NOBLE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:NOBLE
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:LIZZIE GRAHM HG 12 SEVENTH HEHA LWITTIAN LIKES
Mailing Address - Street 2:TOA BZI PR
Mailing Address - City:TOA BZI
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-261-2417
Mailing Address - Fax:
Practice Address - Street 1:EMERGENCY ROOM PANA HOSPITAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-727-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14650207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H78785Medicare UPIN
0021261Medicare ID - Type Unspecified