Provider Demographics
NPI:1528554623
Name:RODRIGUEZ ALVARADO, JESSICA (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RODRIGUEZ ALVARADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 CALLE MARIMAR
Mailing Address - Street 2:BRISAS DEL MAR
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:939-414-5306
Mailing Address - Fax:
Practice Address - Street 1:B5 AVENIDA GAUTIER BENITEZ CONSOLIDATED MALL ANEXO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-9809
Practice Address - Country:US
Practice Address - Phone:787-704-0705
Practice Address - Fax:787-744-7444
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29883163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health