Provider Demographics
NPI:1659093557
Name:RODRIGUEZ, KAISY PAZ
Entity Type:Individual
Prefix:
First Name:KAISY
Middle Name:PAZ
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 VISTA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-2559
Mailing Address - Country:US
Mailing Address - Phone:251-301-3191
Mailing Address - Fax:
Practice Address - Street 1:4000 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1780
Practice Address - Country:US
Practice Address - Phone:251-380-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program