Provider Demographics
NPI:1154828374
Name:RODRIGUEZ, BIANCA JANELLE (RDN)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:JANELLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:JANELLE
Other - Last Name:RODRIGUEZ RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5757
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5757
Mailing Address - Country:US
Mailing Address - Phone:787-344-2765
Mailing Address - Fax:
Practice Address - Street 1:CARR 796 KM 0.5 INT BO GUASABARA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-344-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty