Provider Demographics
NPI:1285827477
Name:RODRIGUEZ, SORAYA
Entity Type:Individual
Prefix:MISS
First Name:SORAYA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GISELA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:J7 CALLE TURQUESA
Mailing Address - Street 2:URB. ESTANCIAS DE YAUCO
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-2800
Mailing Address - Country:US
Mailing Address - Phone:787-856-1922
Mailing Address - Fax:
Practice Address - Street 1:J7 CALLE TURQUESA
Practice Address - Street 2:URB. ESTANCIAS DE YAUCO
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-2800
Practice Address - Country:US
Practice Address - Phone:787-856-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5702183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician