Provider Demographics
NPI:1750040135
Name:RODRIGUEZ RIOS, LUISMIGUEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUISMIGUEL
Middle Name:
Last Name:RODRIGUEZ RIOS
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:PO BOX 262212
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-972-4078
Mailing Address - Fax:
Practice Address - Street 1:BO JAGUEYES CARR. 149 KM. 59.6
Practice Address - Street 2:LOCAL #G-2 (FRENTE AL DESVIO)
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-972-4078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7252103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical