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General NPI Number Information
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NPI Number | 1144898065
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Entity Type | Individual
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Provider Name | ILEANA ROSARIO RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | CARR. 21 NUM. 1785 AVE. LAS LOMAS #21
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City | SAN JUAN
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State | PR
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Zip | 00687
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Country | US
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Telephone | 787-782-9999
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 6388
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City | MOROVIS
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State | PR
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Zip | 00687-8830
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Country | US
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Telephone | 787-236-3905
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11004439
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License Number State | FL
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