Provider Demographics
NPI:1881622942
Name:NAZARIO-RODRIGUEZ, LELIS L (MD)
Entity type:Individual
Prefix:DR
First Name:LELIS
Middle Name:L
Last Name:NAZARIO-RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:UPR MEDICAL SCIENCES CAMPUS, SCHOOL OF MEDICINE
Mailing Address - Street 2:DEPT. OF PSYCHIATRY, PO BOX 365067
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-765-4047
Practice Address - Street 1:UPR MEDICAL SCIENCES CAMPUS, SCHOOL OF MEDICINE
Practice Address - Street 2:DEPT. OF PSYCHIATRY, 9TH FLOOR, OFFICE A-994
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-765-4047
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR116792084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRBX466ZMedicare PIN