Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 656 | PR |
NPI | 1033396924 |
---|---|
Provider Name | Mr. Rahuel Isai Rodriguez |
First Address | Carolina, PR 00982 |
Second Address | Carolina, PR 00984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 23/01/2008 |