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General NPI Number Information
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NPI Number | 1518358225
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Entity Type | Individual
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Provider Name | ANGELIE RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | #326 CALLE 32 VILLA NEVAREZ
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-792-6702
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Fax |
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Provider Business Mailing Address
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Address Line | C1 CALLE 2 PARQUE SAN MIGUEL
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City | BAYAMON
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State | PR
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Zip | 00959-4208
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Country | US
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Telephone | 787-513-1540
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2063
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License Number State | PR
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