Provider Demographics
NPI:1821981911
Name:RODRIGUEZ, JULYANIS ESTEFANY
Entity type:Individual
Prefix:
First Name:JULYANIS
Middle Name:ESTEFANY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JARDINES DE MONACO 2 CALLE DINAMARCA #5
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-6644
Mailing Address - Country:US
Mailing Address - Phone:939-240-9230
Mailing Address - Fax:
Practice Address - Street 1:JARDINES DE MONACO 2 CALLE DINAMARCA #5
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-6644
Practice Address - Country:US
Practice Address - Phone:939-240-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1480224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant