Provider Demographics
NPI:1225201254
Name:RODRIGUEZ, ROSALY (MS SLP)
Entity Type:Individual
Prefix:
First Name:ROSALY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE GEORGETTI # 114
Mailing Address - Street 2:SUITE A
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719
Mailing Address - Country:US
Mailing Address - Phone:787-378-9854
Mailing Address - Fax:787-869-9650
Practice Address - Street 1:114 CALLE GEORGETTI
Practice Address - Street 2:SUITE A
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3011
Practice Address - Country:US
Practice Address - Phone:787-378-9854
Practice Address - Fax:787-869-9650
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist