Provider Demographics
NPI:1306215843
Name:RODRIGUEZ RIOS, KARMIN JEMARIE
Entity Type:Individual
Prefix:
First Name:KARMIN
Middle Name:JEMARIE
Last Name:RODRIGUEZ RIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 CALLE MADAGASCAR
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-3472
Mailing Address - Country:US
Mailing Address - Phone:787-505-7571
Mailing Address - Fax:
Practice Address - Street 1:147 CALLE MADAGASCAR
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-3472
Practice Address - Country:US
Practice Address - Phone:787-505-7571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR96861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical