Provider Demographics
NPI:1568822534
Name:RODRIGUEZ, KRISTY I (PHARM D)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:I
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CALLE REY LUIS
Mailing Address - Street 2:MAN PASEO DE REYES
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-4001
Mailing Address - Country:US
Mailing Address - Phone:939-232-0662
Mailing Address - Fax:
Practice Address - Street 1:3 AVE LOS VETERANOS
Practice Address - Street 2:KM 134.7
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-6333
Practice Address - Country:US
Practice Address - Phone:787-686-9409
Practice Address - Fax:787-866-2075
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist