Provider Demographics
NPI:1821624917
Name:RODRIGUEZ TORRES, MARIELA ADANIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIELA
Middle Name:ADANIS
Last Name:RODRIGUEZ TORRES
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:MONTE LAGO ESTATES 20 BOULEVARD VICTORIA
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:939-334-8030
Mailing Address - Fax:
Practice Address - Street 1:MONTE LAGO ESTATES 20 BOULEVARD VICTORIA
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:939-334-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist