Provider Demographics
NPI:1235105172
Name:RODRIGUEZ, DAPHNE M (MD)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 CALLE ZAMORA
Mailing Address - Street 2:BELMONTE
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-2267
Mailing Address - Country:US
Mailing Address - Phone:787-640-4056
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:UNIVERSITY PEDIATRIC HOSPITAL,DEPARTMENT OF PEDIATRICS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14395208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics