Healthcare Provider Details

I. General information

NPI: 1932656394
Provider Name (Legal Business Name): CATHERINE RODRIGUEZ PHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 CALLE CORVINA ESTANCIAS DE BARCELONETA
BARCELONETA PR
00617-2433
US

IV. Provider business mailing address

247 CALLE CORVINA ESTANCIAS DE BARCELONETA
BARCELONETA PR
00617-2433
US

V. Phone/Fax

Practice location:
  • Phone: 787-996-6420
  • Fax:
Mailing address:
  • Phone: 787-996-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number6695
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: