Provider Demographics
NPI:1013219294
Name:RODRIGUEZ RUIZ, MAURA P (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:P
Last Name:RODRIGUEZ RUIZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DE DIEGO AVE.
Mailing Address - Street 2:2 RES. SAN FERNANDO, APT. 42
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5801
Mailing Address - Country:US
Mailing Address - Phone:787-642-0069
Mailing Address - Fax:
Practice Address - Street 1:DE DIEGO AVE.
Practice Address - Street 2:2 RES. SAN FERNANDO, APT. 42
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5801
Practice Address - Country:US
Practice Address - Phone:787-642-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR870235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist