Individual provider Active NPI

Maria L Robles Rodriguez, OD

  • Optometrist
  • Bayamon, PR
National Provider Identifier
1679570790
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
095 Issued in PR
Practice address
San Fernando
E-18 Ave Hermanas Davila
Bayamon, PR 00957-1769
Phone
(787) 787-4036
Fax
(787) 780-2118
NPI assigned
Jul 5, 2005
Reactivated
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 095 PR Primary
Vision Therapy Optometrist 152WV0400X 095 PR

Addresses

Primary practice location

San Fernando
E-18 Ave Hermanas Davila
Bayamon, PR 00957-1769

Mailing address

PO Box 3423
Bayamon Gardens Station
Bayamon, PR 00958-0423
Phone (787) 787-4036

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)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1679570790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3423",
            "address_2": "BAYAMON GARDENS STATION",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009580423",
            "telephone_number": "787-787-4036",
            "fax_number": "787-780-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN FERNANDO",
            "address_2": "E-18 AVE HERMANAS DAVILA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009571769",
            "telephone_number": "787-787-4036",
            "fax_number": "787-780-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES RODRIGUEZ",
        "first_name": "MARIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-08-12",
        "deactivation_date": "2007-08-20",
        "reactivation_date": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "095",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "PR",
            "license": "095",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.