Provider Demographics
NPI:1578292264
Name:RODRIGUEZ-LABOY, JUAN A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:RODRIGUEZ-LABOY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CALLE C
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-1717
Mailing Address - Country:US
Mailing Address - Phone:787-692-4678
Mailing Address - Fax:
Practice Address - Street 1:60 CALLE C
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-1717
Practice Address - Country:US
Practice Address - Phone:787-692-4678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7437103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical