Provider Demographics
NPI:1477764751
Name:RODRIGUEZ, MINERVA (MSN)
Entity Type:Individual
Prefix:MRS
First Name:MINERVA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO PASEO DEGETAU
Mailing Address - Street 2:APT. 404
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1106 TENIENTE CESAR GONZALEZ
Practice Address - Street 2:VILLA NEVAREZ
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00928
Practice Address - Country:US
Practice Address - Phone:787-758-8019
Practice Address - Fax:787-764-3657
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR013024163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult