Provider Demographics
NPI:1255023438
Name:RODRIGUEZ-PEREZ, ADIANETTE PAOLA
Entity type:Individual
Prefix:
First Name:ADIANETTE
Middle Name:PAOLA
Last Name:RODRIGUEZ-PEREZ
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 1:1034 AVE HOSTOS
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-1115
Mailing Address - Country:US
Mailing Address - Phone:787-843-9393
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION QUINTAS DE FLAMINGO
Practice Address - Street 2:#39 CALLE FLAMINGO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-718-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice