Basic Information
| Provider Information | |||||||||
| NPI: | 1568517829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ RODRIGUEZ | ||||||||
| FirstName: | OLGA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 304 CALLE SOFIA | ||||||||
| Address2: | MANSION REAL | ||||||||
| City: | COTO LAUREL | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007802630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878488816 | ||||||||
| FaxNumber: | 7878417165 | ||||||||
| Practice Location | |||||||||
| Address1: | 388 ZONA IND REPARADA 2 | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007162347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878402575 | ||||||||
| FaxNumber: | 7878409756 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 8327 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 8327 | 01 | PR | LICENSE | OTHER |