Provider Demographics
NPI:1891081931
Name:RODRIGUEZ, ALEX R (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:R
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 CALLEJON A. ROMAN
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00678
Mailing Address - Country:UM
Mailing Address - Phone:787-368-4630
Mailing Address - Fax:
Practice Address - Street 1:7216 CALLEJON A. ROMAN
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00678
Practice Address - Country:UM
Practice Address - Phone:787-368-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7189183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician