Provider Demographics
NPI:1356303119
Name:RODRIGUEZ-VARGAS, DIOMEDES RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DIOMEDES
Middle Name:RAFAEL
Last Name:RODRIGUEZ-VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PASEO DEL PRADO #133
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-502-2971
Mailing Address - Fax:
Practice Address - Street 1:70 CALLE SANTA CRUZ
Practice Address - Street 2:HOSPITAL HIMA SAN PABLO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7052
Practice Address - Country:US
Practice Address - Phone:787-620-9581
Practice Address - Fax:787-653-3588
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15741207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology