Provider Demographics
NPI:1720844244
Name:RODRIGUEZ DE LIEBANA, PAOLA
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:RODRIGUEZ DE LIEBANA
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 1:377 CORREDOR DE LA ARBOLEDA
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-3629
Mailing Address - Country:US
Mailing Address - Phone:787-363-8259
Mailing Address - Fax:
Practice Address - Street 1:377 CORREDOR DE LA ARBOLEDA
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-3629
Practice Address - Country:US
Practice Address - Phone:787-363-8259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program