Provider Demographics
NPI:1033699079
Name:RODRIGUEZ, SONIA ENID (PHARMD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:ENID
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 AVE ARTERIAL B APT 1709
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2204
Mailing Address - Country:US
Mailing Address - Phone:787-367-9147
Mailing Address - Fax:
Practice Address - Street 1:1307 AVE ASHFORD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1325
Practice Address - Country:US
Practice Address - Phone:787-289-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR05525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist