Provider Demographics
NPI:1316048119
Name:AYMAT-RODRIGUEZ, AMARYLLIS (MD)
Entity type:Individual
Prefix:DR
First Name:AMARYLLIS
Middle Name:
Last Name:AYMAT-RODRIGUEZ
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:PLAZA 12 D-9
Mailing Address - Street 2:CAMBRIDGE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1450
Mailing Address - Country:US
Mailing Address - Phone:787-764-6477
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 159 0.9 DESVIO DE COROZAL
Practice Address - Street 2:BARRIO ABRA
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-9750
Practice Address - Country:US
Practice Address - Phone:787-859-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7730208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics