Provider Demographics
NPI:1356678049
Name:GONZALEZ-RODRIGUEZ, NITZA I (PHD)
Entity Type:Individual
Prefix:DR
First Name:NITZA
Middle Name:I
Last Name:GONZALEZ-RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1974
Mailing Address - Street 2:DRA NITZA I. GONZALEZ-RODRIGUEZ
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-1974
Mailing Address - Country:US
Mailing Address - Phone:787-344-7911
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 119 SUR, VICTORIA PLAZA
Practice Address - Street 2:SUITE #5
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-344-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1651103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist