Provider Demographics
NPI:1487256848
Name:RODRIGUEZ, THAIRA ENID (NL)
Entity type:Individual
Prefix:MRS
First Name:THAIRA
Middle Name:ENID
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CALLE AMISTAD
Mailing Address - Street 2:URB LAS CAMPINAS II
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-7306
Mailing Address - Country:US
Mailing Address - Phone:787-503-0104
Mailing Address - Fax:
Practice Address - Street 1:62 CALLE AMISTAD
Practice Address - Street 2:URB LAS CAMPINAS II
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-7306
Practice Address - Country:US
Practice Address - Phone:787-503-0104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath