Healthcare Provider Details

I. General information

NPI: 1760507123
Provider Name (Legal Business Name): SONIA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 12/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA GENERAL VALERO 305
FAJARDO PR
00738
US

IV. Provider business mailing address

PO BOX 999
LUQUILLO PR
00773-0999
US

V. Phone/Fax

Practice location:
  • Phone: 787-863-7788
  • Fax: 787-863-1422
Mailing address:
  • Phone: 787-863-5125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1456
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: