Healthcare Provider Details

I. General information

NPI: 1508428244
Provider Name (Legal Business Name): HECMARIE RODRIGUEZ QUILES RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A21 VILLA SERAL
LARES PR
00669-3002
US

IV. Provider business mailing address

PO BOX 1039
OROCOVIS PR
00720-1039
US

V. Phone/Fax

Practice location:
  • Phone: 939-244-8713
  • Fax:
Mailing address:
  • Phone: 787-452-3658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number86133
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number86133
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: