Healthcare Provider Details

I. General information

NPI: 1245251735
Provider Name (Legal Business Name): LAURA A RODRIGUEZ RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA SAN JUAN VAMC
RIO PIEDRAS PR
00921-3200
US

IV. Provider business mailing address

1307 CALLE MALLORCA MANSIONES VISTAMAR MARINA
CAROLINA PR
00983-1585
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-257-7821
  • Fax: 787-257-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number8621
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: