Provider Demographics
NPI:1669220752
Name:RODRIGUEZ MORALES, JENNYMAR (ND)
Entity type:Individual
Prefix:DR
First Name:JENNYMAR
Middle Name:
Last Name:RODRIGUEZ MORALES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:JENNYMAR
Other - Middle Name:
Other - Last Name:RODRIGUEZ MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:PO BOX 2866
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2866
Mailing Address - Country:US
Mailing Address - Phone:787-900-4933
Mailing Address - Fax:
Practice Address - Street 1:CARR. #3 CLL BERING KM 138.3
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-900-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR102175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath