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MARINAIDA LA SALLE RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
49 CALLE MUNOZ RIVERA, JUNCOS, PR 00777-3112
(787) 435-5582
Mailing address
65 CALLE CAPESTANY, APT. 1, MAYAGUEZ, PR 00680-4049
(787) 435-5582

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17797
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17797
JUNTA DE LICENCIAMIENTO Y DISCIPLINA MEDICA DE PUERTO RICO (LICENSE)
PR
01
80011
JUNTA DE LICENCIAMIENTO Y DISCIPLINA MEDICA DE PUERTO RICO (REGISTRY)
PR
01
DM-17668-5
ASSMCA
PR
Enumeration date
01/20/2010
Last updated
02/15/2018
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