MEDICARE: MYREISHKA MARIE 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	225700000X	Massage Therapist	1344	PR

General Provider Information

NPI Number	:	1982535142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYREISHKA MARIE RODRIGUEZ

Provider Business Mailing Address
First Line	:	210 CALLE SANTA ROSA
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00603-5729
Country	:	US
Telephone Number	:	787-461-7285
Fax Number	:

Provider Business Practice Location Address
First Line	:	PR-2 KM. 124.2 BO. CORRALES
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00603
Country	:	US
Telephone Number	:	787-461-7285
Fax Number	:

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

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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