Provider Demographics
NPI:1659586394
Name:RODRIGUEZ, EDITH MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A19 URB EL MAESTRO
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2708
Mailing Address - Country:US
Mailing Address - Phone:787-817-9752
Mailing Address - Fax:787-879-4211
Practice Address - Street 1:129 KM 3.7 MARGINAL
Practice Address - Street 2:BO HATO ARRIBA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-4210
Practice Address - Fax:787-879-4211
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist