Provider Demographics
NPI:1942297478
Name:RODRIGUEZ, MARIA M (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CALLE SANTA ROSA
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-2067
Mailing Address - Country:US
Mailing Address - Phone:787-265-8840
Mailing Address - Fax:787-265-8825
Practice Address - Street 1:EUGENIO MARIA DE HOSTOS AVE # 345
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-8840
Practice Address - Fax:787-265-8825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist