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General NPI Number Information
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NPI Number | 1013226083
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Entity Type | Individual
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Provider Name | EDWARD SANTIAGO RODRIGUEZ PH.D, M.A.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | SAN GERMAN MEDICAL PLAZA SUITE 2
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City | SAN GERMAN
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State | PR
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Zip | 00683-1560
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Country | US
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Telephone | 787-617-2373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5103 P.M.B. 79
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City | CABO ROJO
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State | PR
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Zip | 00623-5103
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Country | US
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Telephone | 787-617-2373
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1589
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License Number State | PR
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