Provider Demographics
NPI:1124605787
Name:RODRIGUEZ, ALEXIS (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 55100
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-7158
Mailing Address - Country:US
Mailing Address - Phone:787-433-0239
Mailing Address - Fax:
Practice Address - Street 1:88 CARR 2
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5469
Practice Address - Country:US
Practice Address - Phone:787-854-8450
Practice Address - Fax:787-854-8459
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11869183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician