Provider Demographics
NPI:1750595435
Name:RODRIGUEZ, YASHAIRA (MS PHL)
Entity type:Individual
Prefix:MRS
First Name:YASHAIRA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LA ARBOLEDA ST 16
Mailing Address - Street 2:#263
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-617-0005
Mailing Address - Fax:
Practice Address - Street 1:ST CARRION MADURO #45
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-617-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR101522OtherLA CRUZ AZUL DE PR
PR7510052OtherHUMANA HEALTH PLAN OF PR