Provider Demographics
NPI:1548487234
Name:RODRIGUEZ LOPEZ, OSCAR EMILIO (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:EMILIO
Last Name:RODRIGUEZ LOPEZ
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:GENOVA STREET, G-31
Mailing Address - Street 2:EXTENSION VILLA CAPARRA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1730
Mailing Address - Country:US
Mailing Address - Phone:787-630-1525
Mailing Address - Fax:787-793-1913
Practice Address - Street 1:GENOVA STREET, G-31
Practice Address - Street 2:EXTENSION VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1730
Practice Address - Country:US
Practice Address - Phone:787-630-1525
Practice Address - Fax:787-793-1913
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR48102080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4810OtherSTATE PRACTICE LICENSE