Provider Demographics
NPI:1376300848
Name:RODRIGUEZ TORRES, MAYRA
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:RODRIGUEZ TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAYRA
Other - Middle Name:
Other - Last Name:RODRIGUEZ TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:TERRAZAS DE GUAYNABO
Mailing Address - Street 2:H8 ST. CALLE LAS FLORES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5421
Mailing Address - Country:US
Mailing Address - Phone:787-617-7435
Mailing Address - Fax:
Practice Address - Street 1:COND. GOLDEN TOWER
Practice Address - Street 2:LOCAL C-9
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-769-5240
Practice Address - Fax:787-757-0021
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist