Provider Demographics
NPI:1538314117
Name:RODRIGUEZ, MARIA NOEMI (DIETITIAN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:NOEMI
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 CALLE TRINITARIA
Mailing Address - Street 2:URB. BRISAS DE AIBONITO
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3930
Mailing Address - Country:US
Mailing Address - Phone:787-644-2957
Mailing Address - Fax:787-735-7150
Practice Address - Street 1:57 CALLE TRINITARIA
Practice Address - Street 2:URB. BRISAS DE AIBONITO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3930
Practice Address - Country:US
Practice Address - Phone:787-644-2957
Practice Address - Fax:787-735-7150
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1066133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education