MEDICARE: JOHANNE CUBERO RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437018355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNE CUBERO RODRIGUEZ

Provider Business Mailing Address
First Line	:	URB LAS AMERICAS
Second Line	:	CALLE 4 MM25
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-466-1127
Fax Number	:	787-466-1127

Provider Business Practice Location Address
First Line	:	URB LAS AMERICAS
Second Line	:	CALLE 4 MM25
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-466-1127
Fax Number	:	787-466-1127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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