Provider Demographics
NPI:1871243873
Name:SANDOVAL RODRIGUEZ, SAUL ALEXIS (MD)
Entity type:Individual
Prefix:DR
First Name:SAUL
Middle Name:ALEXIS
Last Name:SANDOVAL RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CROWN HILLS CALLE GUAMAI 1768, SAN JUAN PR, 00926
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-697-6938
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL PEDIATRICO OFICINA 1-A-35
Practice Address - Street 2:CARR. 22, BO. MONACILLOS, CENTRO MEDICO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-474-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17202-I207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine