Anibal A Rodriguez, MD

Individual provider Active NPI General Practice Physician · Bayamon, PR

NPI 1114010147 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114010147
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
12636 (PR)
Practice address
Calle Rossi Esq Degetau
Bayamon, PR 00960
Phone
(787) 798-4259
Fax
(787) 269-5230
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050825000272 PR Practitioner - General Practice 6901837376 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Municipio de Bayamon Current
since Jan 27, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 12636 PR Yes

Addresses

Primary practice location

Calle Rossi Esq Degetau
Bayamon, PR 00960

Mailing address

PO Box 51036
Levittown Station
Toa Baja, PR 00950
Phone (787) 640-3815

Other providers in Bayamon, PR

All providers in Bayamon, PR · General Practice Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.