Provider Demographics
NPI:1174403729
Name:RODRIGUEZ, ANA IVETTE (PHD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:IVETTE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1292
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718-1292
Mailing Address - Country:US
Mailing Address - Phone:787-366-6519
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1292
Practice Address - Street 2:BO. MARIANA RR 9973
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718-1292
Practice Address - Country:US
Practice Address - Phone:787-366-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR461862471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty