Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 886 | PR |
NPI | 1023260395 |
---|---|
Provider Name | Patricia Rodriguez |
First Address | Hatillo, PR 00659-9711 |
Second Address | Hatillo, PR 00659-9711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2008 |
Last Update Date | 18/10/2008 |