Provider Demographics
NPI:1093361016
Name:RODRIGUEZ LOPEZ, LEYSHLA NICOLE
Entity Type:Individual
Prefix:
First Name:LEYSHLA
Middle Name:NICOLE
Last Name:RODRIGUEZ LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E141 CALLE VALLADOLID
Mailing Address - Street 2:URB VISTAMAR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-528-1681
Mailing Address - Fax:
Practice Address - Street 1:1503 CALLE PROF AUGUSTO RODRIGUEZ
Practice Address - Street 2:CONDOMINIO ASIA, SUITE 300
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-705-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other