Provider Demographics
NPI:1306045836
Name:RODRIGUEZ, ARCANGEL (PH D)
Entity Type:Individual
Prefix:
First Name:ARCANGEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6915
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-9729
Mailing Address - Country:US
Mailing Address - Phone:787-835-0526
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 6915
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-9729
Practice Address - Country:US
Practice Address - Phone:787-835-0526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2898103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist