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General NPI Number Information
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NPI Number | 1083161418
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Entity Type | Individual
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Provider Name | ROSA DEL MAR RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1607 PONCE DE LEON AVE COBIAN'S PLAZA BUILDING SUITE 305
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City | SAN JUAN
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State | PR
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Zip | 00940
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Country | US
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Telephone | 787-320-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 609 CALLE CUEVILLAS APARTMENT 8A MIRAMAR
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-320-3733
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 005564
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License Number State | PR
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