Provider Demographics
NPI:1205454733
Name:RODRIGUEZ, STELLA M (PA)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:M
Last Name:RODRIGUEZ
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 1039
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-1039
Mailing Address - Country:US
Mailing Address - Phone:787-923-7169
Mailing Address - Fax:787-963-0810
Practice Address - Street 1:100 GRAND PASEO BLVD
Practice Address - Street 2:GALERIA PASEOS MALL 112 STE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5905
Practice Address - Country:US
Practice Address - Phone:787-923-7169
Practice Address - Fax:787-963-0810
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical