Provider Demographics
NPI:1447380951
Name:RODRIGUEZ, NORMA IRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:IRIS
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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 8428
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8428
Mailing Address - Country:US
Mailing Address - Phone:787-653-7246
Mailing Address - Fax:787-653-7332
Practice Address - Street 1:30 CALLE PADIAL
Practice Address - Street 2:PLAZA GATSBY SUITE 210
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-9999
Practice Address - Country:US
Practice Address - Phone:787-653-7246
Practice Address - Fax:787-653-7332
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10542261QM0801X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20171Medicare UPIN