Provider Demographics
NPI:1366773004
Name:RODRIGUEZ, CHTRISTINA MARIA
Entity type:Individual
Prefix:
First Name:CHTRISTINA
Middle Name:MARIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 107 # KM 3/5
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5970
Mailing Address - Country:US
Mailing Address - Phone:787-891-5479
Mailing Address - Fax:787-882-1535
Practice Address - Street 1:HC 4 BOX 40018
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9764
Practice Address - Country:US
Practice Address - Phone:787-444-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7963183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician