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General NPI Number Information
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NPI Number | 1568679637
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Entity Type | Individual
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Provider Name | EDUARDO ANDRES RODRIGUEZ PH.D
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MEDICAL PAVILLION SUITE NO. 4 PARADA 20 SAN RAFAEL 1396
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City | SANTURCE
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-2910
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Fax |
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Provider Business Mailing Address
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Address Line | 52 CALLE VILLAMIL CONDADO
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City | SAN JUAN
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State | PR
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Zip | 00907-1813
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Country | US
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Telephone | 787-724-1704
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2801
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License Number State | PR
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