Individual provider Active NPI

Erick Jr Rodriguez

  • Administrator Registered Nurse
  • Carolina, PR
National Provider Identifier
1104507433
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
85121 Issued in PR
Practice address
10 Ave, 44 Ave Laguna Ste, 101a
Carolina, PR 00979
Phone
(787) 791-7287
NPI assigned
Jul 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 85121 PR Primary

Addresses

Primary practice location

10 Ave, 44 Ave Laguna Ste, 101a
Carolina, PR 00979

Mailing address

Cond. Alturas del Parque Apto. 1706
202 Boul. Media Luna
Carolina, PR 00987
Phone (787) 349-9428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
85121PRMDAdministrator Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1104507433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND. ALTURAS DEL PARQUE APTO. 1706",
            "address_2": "202 BOUL. MEDIA LUNA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-349-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 AVE, 44 AVE LAGUNA STE, 101A",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-791-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ERICK",
        "middle_name": "JR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "PR",
            "license": "85121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.