Provider Demographics
NPI:1265640890
Name:RODRIGUEZ QUINONES, IRIS BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:BETH
Last Name:RODRIGUEZ QUINONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1574 CALLE BORI
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6113
Mailing Address - Country:US
Mailing Address - Phone:787-299-2307
Mailing Address - Fax:
Practice Address - Street 1:1574 CALLE BORI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6113
Practice Address - Country:US
Practice Address - Phone:787-299-2307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical