Healthcare Provider Details

I. General information

NPI: 1497458848
Provider Name (Legal Business Name): LESLIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 08/12/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL PEDIATRICO UNIVERSITARIO, CENTRO MEDICO CARR. 22, BO. MONACILLOS, RIO PIEDRAS
SAN JUAN PR
00921
US

IV. Provider business mailing address

HOSPITAL PEDIATRICO UNIVERSITARIO, CENTRO MEDICO CARR. 22, BO. MONACILLOS, RIO PIEDRAS
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-0333
  • Fax:
Mailing address:
  • Phone: 787-474-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17547
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: