Provider Demographics
NPI:1740751577
Name:RODRIGUEZ CARDONA, ASTRID REBECCA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:REBECCA
Last Name:RODRIGUEZ CARDONA
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1668
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8668
Mailing Address - Country:US
Mailing Address - Phone:787-245-2636
Mailing Address - Fax:
Practice Address - Street 1:104 CALLE 678
Practice Address - Street 2:#99
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-270-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6595OtherLICENSE