Healthcare Provider Details

I. General information

NPI: 1942875968
Provider Name (Legal Business Name): JAYLEEN RODRIGUEZ LAMELA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAYLEEN RODRIGUEZ LAMELA RN

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 110 INTERSECCION CARR 111
MOCA PR
00676
US

IV. Provider business mailing address

PO BOX 71474
SAN JUAN PR
00936-8574
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-9133
  • Fax:
Mailing address:
  • Phone: 787-641-9133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number87172
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: