Provider Demographics
NPI:1164585873
Name:RIOS RODRIGUEZ, LYNETTE (RPT)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:RIOS RODRIGUEZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 5 BLOQUE C NUMERO 20
Mailing Address - Street 2:ESTANCIAS DE SAN FERNANDO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-637-4897
Mailing Address - Fax:787-276-7030
Practice Address - Street 1:4ES12 AVENIDA FRAGOSO
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-276-7006
Practice Address - Fax:787-276-7030
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist