Healthcare Provider Details

I. General information

NPI: 1730008731
Provider Name (Legal Business Name): MIOSOLYS IVETTE RODRIGUEZ HERNANDEZ MSPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 CALLE MILLITO NAVARRO
PONCE PR
00730-0523
US

IV. Provider business mailing address

421 CALLE MILLITO NAVARRO
PONCE PR
00730-0523
US

V. Phone/Fax

Practice location:
  • Phone: 787-449-1539
  • Fax:
Mailing address:
  • Phone: 787-449-1539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9167
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: