Individual provider Active NPI

Alexandra Rodriguez, LND, RD

  • Nutritionist
  • Carolina, PR
National Provider Identifier
1396096012
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1656 Issued in PR
Practice address
Calle 3 Ave 65TH Infanteria
Carolina, PR 00984
Phone
(787) 757-1800
NPI assigned
Sep 20, 2012
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1656 PR Primary

Addresses

Primary practice location

Calle 3 Ave 65TH Infanteria
Carolina, PR 00984

Mailing address

19-15 Calle 21
Bayamon, PR 00961-4517
Phone (787) 671-6831

Other identifiers 1

IdentifierTypeStateIssuer
1656OtherPRDIETITIANS LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1656PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. Nutritionist CurrentSince Mar 14, 2015 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Mar 14, 2015 Accepting new patients

Locations

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1396096012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-15 CALLE 21",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009614517",
            "telephone_number": "787-671-6831",
            "fax_number": "787-771-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 3 AVE 65TH INFANTERIA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00984",
            "telephone_number": "787-757-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALEXANDRA",
        "credential": "LND, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIANS LICENSE",
            "identifier": "1656",
            "state": "PR"
        }
    ],
    "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 May 22, 2024; 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.