Provider Demographics
NPI:1548404593
Name:RODRIGUEZ, DORIS (PROVIDER)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2537
Mailing Address - Country:US
Mailing Address - Phone:207-878-4684
Mailing Address - Fax:207-878-4683
Practice Address - Street 1:134 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2537
Practice Address - Country:US
Practice Address - Phone:207-878-4684
Practice Address - Fax:207-878-4683
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME220390000Medicaid