Provider Demographics
NPI:1255846564
Name:DIAZ RODRIGUEZ, ANAIRY (PSYD)
Entity type:Individual
Prefix:
First Name:ANAIRY
Middle Name:
Last Name:DIAZ RODRIGUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TERRS DEL MONTE 59 CALLE PINO
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-2515
Mailing Address - Country:US
Mailing Address - Phone:787-923-3300
Mailing Address - Fax:
Practice Address - Street 1:CARR 198 KM 21.7
Practice Address - Street 2:BO. ARENAS
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-9664
Practice Address - Country:US
Practice Address - Phone:787-923-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5918103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR39870900Medicaid