Provider Demographics
NPI:1922233642
Name:MARTA RODRIGUEZ
Entity Type:Organization
Organization Name:MARTA RODRIGUEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:787-785-7144
Mailing Address - Street 1:PO BOX 8055
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8055
Mailing Address - Country:US
Mailing Address - Phone:787-785-7144
Mailing Address - Fax:866-954-2039
Practice Address - Street 1:AA-7 CALLE 24
Practice Address - Street 2:FLAMBOYAN GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3650
Practice Address - Country:US
Practice Address - Phone:787-785-7144
Practice Address - Fax:866-954-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6138320001Medicare NSC
PR1136300001Medicare NSC