Provider Demographics
NPI:1598886087
Name:RODRIGUEZ, ITZA EMIR
Entity Type:Individual
Prefix:MRS
First Name:ITZA
Middle Name:EMIR
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ITZA
Other - Middle Name:EMIR
Other - Last Name:GIRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3128 W MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-1004
Mailing Address - Country:US
Mailing Address - Phone:520-908-0808
Mailing Address - Fax:
Practice Address - Street 1:3128 W MONTANA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-1004
Practice Address - Country:US
Practice Address - Phone:520-908-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant