Provider Demographics
NPI:1730170010
Name:OROZCO, RODOLFO (MD)
Entity type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:
Last Name:OROZCO
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 51911
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1911
Mailing Address - Country:US
Mailing Address - Phone:787-261-6199
Mailing Address - Fax:787-261-3552
Practice Address - Street 1:G24 CALLE MAGDA E
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4510
Practice Address - Country:US
Practice Address - Phone:787-261-6199
Practice Address - Fax:787-361-3552
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF85652Medicare UPIN