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General NPI Number Information
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NPI Number | 1275899817
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Entity Type | Organization
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Legal Business Name | ADRIALEX,INC.
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | URBANIZACION JUAN MENDOZA CALLE 3 # 1
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City | NAGUABO
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State | PR
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Zip | 00718
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Country | US
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Telephone | 787-206-2410
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Fax |
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Provider Business Mailing Address
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Address Line | BZ. 738 BO.DAGUAO
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City | NAGUABO
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State | PR
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Zip | 00718-2903
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Country | US
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Telephone | 787-206-2410
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JOVINA RODRIGUEZ
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Credential | O.D.
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Telephone | 787-206-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 487/281
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License Number State | PR
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