Provider Demographics
NPI:1376881540
Name:DE LA PAZ RODRIGUEZ, ABDIEL ELIAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ABDIEL
Middle Name:ELIAS
Last Name:DE LA PAZ RODRIGUEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ABDIEL
Other - Middle Name:ELIAS
Other - Last Name:DE LA PAZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:URB. CHALETS DE LA FUENTE II,
Mailing Address - Street 2:CALLE MONTE CASINO, CASA #8
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-463-8377
Mailing Address - Fax:
Practice Address - Street 1:CARR. 848 SAN ANTON
Practice Address - Street 2:CENTRO COMERCIAL PLAZA 66 ST 5C
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-463-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical