Provider Demographics
NPI:1629962394
Name:DEL VALLE RODRIGUEZ, LILLYANETTE (SRNA)
Entity type:Individual
Prefix:
First Name:LILLYANETTE
Middle Name:
Last Name:DEL VALLE RODRIGUEZ
Suffix:
Gender:F
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SECT OTERO
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3269
Mailing Address - Country:US
Mailing Address - Phone:787-460-9564
Mailing Address - Fax:
Practice Address - Street 1:MAYAGUEZ MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1560
Practice Address - Country:US
Practice Address - Phone:787-460-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100139163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse