Provider Demographics
NPI:1992307599
Name:RODRIGUEZ BREA, JANICE (NL)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:RODRIGUEZ BREA
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 1:140 CARR 842 APT 2606
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9758
Mailing Address - Country:US
Mailing Address - Phone:939-414-7383
Mailing Address - Fax:
Practice Address - Street 1:140 CARR 842 APT 2606
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9758
Practice Address - Country:US
Practice Address - Phone:939-414-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
203OtherNATURPATA LICENCIADA