Provider Demographics
NPI:1417630054
Name:RODRIGUEZ, MARIELA DEL CARMEN (PHD)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:DEL CARMEN
Last Name: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 101
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0101
Mailing Address - Country:US
Mailing Address - Phone:787-221-2544
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL METROPOLITANO DR. SUSONI
Practice Address - Street 2:55 PALM STREET
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-5200
Practice Address - Country:US
Practice Address - Phone:787-221-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service