Provider Demographics
NPI:1417596743
Name:RODRIGUEZ, ROSALINDA (CPHT)
Entity Type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W 6TH ST BLDG B113
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0300
Mailing Address - Country:US
Mailing Address - Phone:520-621-0450
Mailing Address - Fax:
Practice Address - Street 1:220 W 6TH ST BLDG B113
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0300
Practice Address - Country:US
Practice Address - Phone:520-621-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
AZT000739183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No174H00000XOther Service ProvidersHealth Educator