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General NPI Number Information
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NPI Number | 1326238213
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Entity Type | Individual
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Provider Name | LENNISSE VANESSA RODRIGUEZ L.N.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | CARR #2 KM 96.8 BARRIO COCOS ALTOS FARMACIA GLORIANA
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0776
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Country | US
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Telephone | 787-895-5136
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Fax | 787-895-5136
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Provider Business Mailing Address
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Address Line | PO BOX 776
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0776
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Country | US
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Telephone | 787-895-5136
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Fax | 787-895-5136
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 1310
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License Number State | PR
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