MEDICARE: SOLMARIE RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	36452	PR

General Provider Information

NPI Number	:	1174901052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLMARIE RODRIGUEZ

Provider Business Mailing Address
First Line	:	303 CALLE ARZUAGA ESQUINA SAN RAFAEL 25
Second Line	:	CONDOMINIO EL BOQUIO APT 2
City	:	CAROLINA
State	:	PR
Zip	:	00985
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	385 AVE DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3718
Country	:	US
Telephone Number	:	787-613-1544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	05/12/2015

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