Healthcare Provider Details

I. General information

NPI: 1063499317
Provider Name (Legal Business Name): LUZ M PEIER RODRIGUEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA 65 DE INFANTERIA KM 34 BARRIO SABANA LLANA
SAN JUAN PR
00924
US

IV. Provider business mailing address

CALLE 20 W6 CASTELLANA GARDEN
CAROLINA PR
00983
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-7676
  • Fax: 787-764-9904
Mailing address:
  • Phone: 787-767-7676
  • Fax: 787-764-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number8123
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: