Provider Demographics
NPI:1184745044
Name:RODRIGUEZ, YASEF MOHAR
Entity type:Individual
Prefix:
First Name:YASEF
Middle Name:MOHAR
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROAD 693
Mailing Address - Street 2:PMB #281 425
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4802
Mailing Address - Country:US
Mailing Address - Phone:787-632-1724
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE ALELI
Practice Address - Street 2:MONTE ELENA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5601
Practice Address - Country:US
Practice Address - Phone:787-632-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5691183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician