Healthcare Provider Details

I. General information

NPI: 1992761282
Provider Name (Legal Business Name): YAZMIN RIOS RODRIGUEZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER PLAZA 740 AVE HOSTOS SUITE 202
MAYAGUEZ PR
00682
US

IV. Provider business mailing address

PO BOX 596
MAYAGUEZ PR
00681-0596
US

V. Phone/Fax

Practice location:
  • Phone: 787-444-1120
  • Fax:
Mailing address:
  • Phone: 787-444-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2588
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: