Healthcare Provider Details

I. General information

NPI: 1013501287
Provider Name (Legal Business Name): ALEXANDRA ISABEL RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO BARRIO MONACILLOS
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

PO BOX 365067
SAN JUAN PR
00936-5067
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24369
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: