Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 19689 | PR |
NPI | 1104266006 |
---|---|
Provider Name | Dr. Janice Rodriguez Hernandez |
First Address | San Juan, PR 00918 |
Second Address | Guaynabo, PR 00968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 19/07/2019 |