Healthcare Provider Details

I. General information

NPI: 1780552562
Provider Name (Legal Business Name): JOSETH ANTONIO RODRIGUEZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11217 AV. 65 DE INFANTERIA
CAROLINA PR
00987
US

IV. Provider business mailing address

HC 2 BOX 9955
GUAYANILLA PR
00656-9775
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-7191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8538
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: