Provider Demographics
NPI:1992412894
Name:RODRIGUEZ BARRERA, ISABEL CRISTINA
Entity type:Individual
Prefix:MRS
First Name:ISABEL
Middle Name:CRISTINA
Last Name:RODRIGUEZ BARRERA
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 1:3650 CALLE CONCHA
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-3212
Mailing Address - Country:US
Mailing Address - Phone:787-485-3662
Mailing Address - Fax:
Practice Address - Street 1:3650 CALLE CONCHA
Practice Address - Street 2:SANTA TERESITA
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:939-525-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1108133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist