Provider Demographics
NPI:1548278070
Name:RODRIGUEZ, ORLANDO L (MD)
Entity type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:L
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:PO BOX 1134
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1134
Mailing Address - Country:US
Mailing Address - Phone:787-854-9648
Mailing Address - Fax:787-884-2523
Practice Address - Street 1:EXT SAN SALVADOR MARGINAL 4
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-9648
Practice Address - Fax:787-884-2523
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6168174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC82478Medicare UPIN
PR0029849Medicare ID - Type Unspecified