Active NPI
Lidiette Marie Rodriguez, RDN
- Registered Dietitian
- Manati, PR
National Provider Identifier
1104638097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1890
- Practice address
- 2 Calle Bella Vista
Manati, PR 00674 - Phone
- (787) 390-0487
- NPI assigned
- Jan 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1890 | PR | Primary |
Addresses
Primary practice location
2 Calle Bella Vista
Manati, PR 00674
Mailing address
HC 74 Box 6669
Cayey, PR 00736-9111
Phone (787) 390-0487
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1890 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737936000000",
"number": "1104638097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 74 BOX 6669",
"city": "CAYEY",
"state": "PR",
"postal_code": "007369111",
"telephone_number": "787-390-0487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CALLE BELLA VISTA",
"city": "MANATI",
"state": "PR",
"postal_code": "00674",
"telephone_number": "787-390-0487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LIDIETTE",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-27",
"last_updated": "2025-01-27",
"certification_date": "2025-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.