Provider Demographics
NPI:1275720120
Name:RODRIGUEZ, DELMA (BS MT)
Entity Type:Individual
Prefix:
First Name:DELMA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BS MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 PASEO DE LA REINA
Mailing Address - Street 2:MIGUEL POU
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2441
Mailing Address - Country:US
Mailing Address - Phone:787-445-8267
Mailing Address - Fax:787-824-1003
Practice Address - Street 1:3302 PASEO DE LA REINA
Practice Address - Street 2:MIGUEL POU
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2441
Practice Address - Country:US
Practice Address - Phone:787-445-8267
Practice Address - Fax:787-824-1003
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3121246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory