1952656001 NPI number — JOSE MANUEL RODRIGUEZ-BARRANTES MD

Table of content: JOSE MANUEL RODRIGUEZ-BARRANTES MD (NPI 1952656001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952656001 NPI number — JOSE MANUEL RODRIGUEZ-BARRANTES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ-BARRANTES
Provider First Name:
JOSE
Provider Middle Name:
MANUEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952656001
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2660 10TH AVE S
Provider Second Line Business Mailing Address:
PROFESSIONAL BUILDING 1, SUITE 720
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35205-1605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-930-2466
Provider Business Mailing Address Fax Number:
205-930-2469

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2660 10TH AVE S
Provider Second Line Business Practice Location Address:
PROFESSIONAL BUILDING 1, SUITE 720
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205-1605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-930-2466
Provider Business Practice Location Address Fax Number:
205-930-2469
Provider Enumeration Date:
07/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L3461.R , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: MD.33596 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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