Provider Demographics
NPI:1568855047
Name:MONROIG RODRIGUEZ, EDIA ENID
Entity Type:Individual
Prefix:
First Name:EDIA
Middle Name:ENID
Last Name:MONROIG RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 9982
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-6460
Mailing Address - Country:US
Mailing Address - Phone:787-370-1767
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 9982
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-6460
Practice Address - Country:US
Practice Address - Phone:787-370-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist