Healthcare Provider Details

I. General information

NPI: 1497553705
Provider Name (Legal Business Name): ARIANNA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. VALPARAISO J29 CALLE 4
TOA BAJA PR
00949
US

IV. Provider business mailing address

URB. CIUDAD JARDIN 3 CALLE ILAN-ILAN #343
TOA ALTA PR
00953-4899
US

V. Phone/Fax

Practice location:
  • Phone: 939-202-9296
  • Fax:
Mailing address:
  • Phone: 787-664-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8273
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8273
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: