Provider Demographics
NPI:1467422881
Name:RODRIGUEZ, ALEXANDRA SOFIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:SOFIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MANSIONES DE GARDEN HILLS
Mailing Address - Street 2:ST. #8 D-3
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-782-2195
Mailing Address - Fax:
Practice Address - Street 1:1725 CALLE YANGTZE
Practice Address - Street 2:RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3152
Practice Address - Country:US
Practice Address - Phone:787-758-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24101223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry