Provider Demographics
NPI:1104266006
Name:RODRIGUEZ HERNANDEZ, JANICE (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:RODRIGUEZ HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 CALLE SERGIO CUEVAS
Mailing Address - Street 2:COND TORRE DEL CARDENAL APTO 601 BOX 33
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-751-2509
Mailing Address - Fax:
Practice Address - Street 1:MARAMAR PLAZA 1270
Practice Address - Street 2:101 AVE SAN PATRICIO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-751-2509
Practice Address - Fax:787-781-5307
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR196892084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology