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General NPI Number Information
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NPI Number | 1023750882
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Entity Type | Individual
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Provider Name | LEONARDO ANDRE RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 05/28/2023
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Provider Practice Location Address
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Address Line | 35 AV. JUAN CARLOS DE BORBON STREET 77
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-287-3725
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Fax |
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Provider Business Mailing Address
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Address Line | URB. PONCE DE LEON CALLE 22 APT. 155B
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 939-642-6281
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 2985
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8075
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License Number State | PR
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