Healthcare Provider Details

I. General information

NPI: 1346173903
Provider Name (Legal Business Name): BETLYAN RODRIGUEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA JOSE GAUTIER BENITEZ NUMERO 230 BO. PUEBLO
CAGUAS PR
00725-0000
US

IV. Provider business mailing address

PO BOX 943
JUNCOS PR
00777-0943
US

V. Phone/Fax

Practice location:
  • Phone: 787-445-0095
  • Fax:
Mailing address:
  • Phone: 787-445-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17328
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: