Provider Demographics
NPI:1578389524
Name:RODRIGUEZ ORTIZ, JOANNE LIZ (DC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:LIZ
Last Name:RODRIGUEZ ORTIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CALLE DON EULOGIO
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-5055
Mailing Address - Country:US
Mailing Address - Phone:939-202-0284
Mailing Address - Fax:
Practice Address - Street 1:199 AVE TRIO VEGABAJENO
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-5818
Practice Address - Country:US
Practice Address - Phone:787-800-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor