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General NPI Number Information
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NPI Number | 1407883168
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Entity Type | Individual
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Provider Name | LORNA AIMEE RODRIGUEZ D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 1453 AVE SAN IGNACIO ALTAMESA
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City | SAN JUAN
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State | PR
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Zip | 00921-4718
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Country | US
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Telephone | 787-792-1391
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Fax | 797-792-1391
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Provider Business Mailing Address
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Address Line | PO BOX 2440
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City | GUAYNABO
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State | PR
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Zip | 00970
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Country | US
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Telephone | 787-792-1391
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Fax | 787-792-1391
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1179
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License Number State | PR
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