Healthcare Provider Details

I. General information

NPI: 1477457075
Provider Name (Legal Business Name): YERALIS E RODRIGUEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB EL MADRIGAL CALLE 6 G18A
PONCE PR
00730
US

IV. Provider business mailing address

URB EL MADRIGAL CALLE 6 G18A
PONCE PR
00730
US

V. Phone/Fax

Practice location:
  • Phone: 787-432-2801
  • Fax:
Mailing address:
  • Phone: 787-432-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9674987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: