Provider Demographics
NPI:1902866197
Name:RODRIGUEZ, MARITZA (DSC, MA,BA,ATC)
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DSC, MA,BA,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W CONTINENTAL RD
Mailing Address - Street 2:SUITE 181-E/F
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-3624
Mailing Address - Country:US
Mailing Address - Phone:520-625-1622
Mailing Address - Fax:520-625-1655
Practice Address - Street 1:275 W CONTINENTAL RD
Practice Address - Street 2:SUITE #181 E/F
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-3624
Practice Address - Country:US
Practice Address - Phone:520-625-1622
Practice Address - Fax:520-625-1655
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2255A2300X2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ22OtherRESPIRATORY,REHABILITATIO