Provider Demographics
NPI:1376111344
Name:RODRIGUEZ, CARMEN HILDA (NL)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:HILDA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NL
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 562
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0562
Mailing Address - Country:US
Mailing Address - Phone:787-478-1084
Mailing Address - Fax:
Practice Address - Street 1:3 MADRID
Practice Address - Street 2:URB BATISTA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-478-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath