Provider Demographics
NPI:1386032001
Name:RODRIGUEZ-GONZALEZ, ILEANA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ILEANA
Middle Name:
Last Name:RODRIGUEZ-GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 AVE LOS DOMINICOS
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3400
Mailing Address - Country:US
Mailing Address - Phone:787-795-2083
Mailing Address - Fax:787-795-2053
Practice Address - Street 1:35 AVE LOS DOMINICOS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3400
Practice Address - Country:US
Practice Address - Phone:787-795-2083
Practice Address - Fax:787-795-2053
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist