Basic Information
| Provider Information | |||||||||
| NPI: | 1528554623 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ ALVARADO | ||||||||
| FirstName: | JESSICA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1032 CALLE MARIMAR | ||||||||
| Address2: | BRISAS DEL MAR | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9394145306 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | B5 AVENIDA GAUTIER BENITEZ CONSOLIDATED MALL ANEXO | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007269809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877040705 | ||||||||
| FaxNumber: | 7877447444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2018 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 29883 | PR | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.