Healthcare Provider Details

I. General information

NPI: 1790796399
Provider Name (Legal Business Name): YECENIA L RODRIGUEZ RM,MSN,CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#10 CASIA ST.
SAN JUAN PR
00921-3201
US

IV. Provider business mailing address

HORTENSIA ST, COND. SKY TOWER II APT 1-H
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-391-5154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number24513
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: