Provider Demographics
NPI:1629281688
Name:GARCIA-RODRIGUEZ, SAN JUANA (R, PH)
Entity Type:Individual
Prefix:MRS
First Name:SAN JUANA
Middle Name:
Last Name:GARCIA-RODRIGUEZ
Suffix:
Gender:F
Credentials:R, PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 S. W. 68 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-270-1607
Mailing Address - Fax:
Practice Address - Street 1:5000 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:786-308-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 22838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist