Provider Demographics
NPI:1306439666
Name:INFANTE RODRIGUEZ, JAYSHA LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAYSHA
Middle Name:LEE
Last Name:INFANTE RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE BOHEMIA 1163
Mailing Address - Street 2:URB. PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-340-2404
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS #222 LOS COLOBOS
Practice Address - Street 2:150 CARRETERA 857
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-701-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist