Active NPI
Rafael Rodriguez, M.D.
- Pediatrics Physician
- Bayamon, PR
National Provider Identifier
1407921760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 08088
- Practice address
- PMB Suite 145
Ave. 90 Rio Hondo
Bayamon, PR 00961-3113 - Phone
- (787) 378-1040
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 08088 | PR | Primary |
Addresses
Primary practice location
PMB Suite 145
Ave. 90 Rio Hondo
Bayamon, PR 00961-3113
Mailing address
110 Esmeralda
Cielo Dorado Village
Vega Alta, PR 00692
Phone (787) 270-1506
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2-8088 | Other | PR | MCS |
| 82919-RO | Other | PR | TRIPLE-S |
| 203302 | Other | PR | PREFFERED HEALTH |
| 7232 | Other | PR | INTERNATIAL MEDICAL CARD |
| 7830002 | Other | PR | HUMANA INSURANCE |
| M-1915 | Other | PR | CRUZ AZUL |
| 08088 | Other | PR | STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08088 | PR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407921760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ESMERALDA",
"address_2": "CIELO DORADO VILLAGE",
"city": "VEGA ALTA",
"state": "PR",
"postal_code": "00692",
"telephone_number": "787-270-1506",
"fax_number": "787-870-1508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PMB SUITE 145",
"address_2": "AVE. 90 RIO HONDO",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009613113",
"telephone_number": "787-378-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "RAFAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "08088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCS",
"identifier": "2-8088",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE-S",
"identifier": "82919-RO",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFFERED HEALTH",
"identifier": "203302",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNATIAL MEDICAL CARD",
"identifier": "7232",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA INSURANCE",
"identifier": "7830002",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRUZ AZUL",
"identifier": "M-1915",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "08088",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.