Provider Demographics
NPI:1326471467
Name:RODRIGUEZ, MARIA ELISA (SW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELISA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VIA PLAYERA 1003
Mailing Address - Street 2:URBANIZACION CAMINO DEL MAR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-969-6847
Mailing Address - Fax:
Practice Address - Street 1:VIA PLAYERA 1003
Practice Address - Street 2:URBANIZACION CAMINO DEL MAR
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-969-6847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2076701171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7890OtherSOCIAL WORKER