Provider Demographics
NPI:1568660710
Name:RODRIGUEZ, ZULMA M (MS)
Entity Type:Individual
Prefix:MRS
First Name:ZULMA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 505 P.O. BOX 7886
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7886
Mailing Address - Country:US
Mailing Address - Phone:787-789-5528
Mailing Address - Fax:
Practice Address - Street 1:716 AVE. PONCE DE LEON
Practice Address - Street 2:OFICINA 204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00970
Practice Address - Country:US
Practice Address - Phone:787-764-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1929103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist