Provider Demographics
NPI:1134828452
Name:RODRIGUEZ PAGAN, KATHIA YARI (RDN)
Entity type:Individual
Prefix:
First Name:KATHIA
Middle Name:YARI
Last Name:RODRIGUEZ PAGAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CALLE RODRIGO DE TRIANA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3207
Mailing Address - Country:US
Mailing Address - Phone:787-306-2906
Mailing Address - Fax:
Practice Address - Street 1:131 CALLE RODRIGO DE TRIANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3207
Practice Address - Country:US
Practice Address - Phone:787-306-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86104845133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered