Provider Demographics
NPI:1932334885
Name:RODRIGUEZ-GALLARDO, IRIS V (RPH)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:V
Last Name:RODRIGUEZ-GALLARDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CALLE RIGEL
Mailing Address - Street 2:URB LOS ANGELES
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-1637
Mailing Address - Country:US
Mailing Address - Phone:787-501-4401
Mailing Address - Fax:
Practice Address - Street 1:30 CALLE RIGEL
Practice Address - Street 2:URB LOS ANGELES
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-1637
Practice Address - Country:US
Practice Address - Phone:787-501-4401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist