Healthcare Provider Details

I. General information

NPI: 1730090374
Provider Name (Legal Business Name): PAOLA ANDREA RODRIGUEZ SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 AVE TITO CASTRO STE 113
PONCE PR
00716-0203
US

IV. Provider business mailing address

1213 BULEVAR SAN LUIS VILLAS DE LAUREL I
COTO LAUREL PR
00780-2243
US

V. Phone/Fax

Practice location:
  • Phone: 787-221-3978
  • Fax:
Mailing address:
  • Phone: 787-221-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1164
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: