Provider Demographics
NPI:1871876110
Name:RODRIGUEZ-HERNANDEZ, SONY J
Entity type:Individual
Prefix:
First Name:SONY
Middle Name:J
Last Name:RODRIGUEZ-HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142513
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-2513
Mailing Address - Country:US
Mailing Address - Phone:787-817-9702
Mailing Address - Fax:787-878-0075
Practice Address - Street 1:EXT. SAN SALVADOR, MARGINAL #4
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-9648
Practice Address - Fax:787-884-2523
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18328208M00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice