Provider Demographics
NPI:1942567680
Name:RODRIGUEZ, MARIA EUGENIA (MS, RD, CSR, LND)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:EUGENIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, RD, CSR, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 523
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-402-7304
Mailing Address - Fax:
Practice Address - Street 1:C-6 CAMINO ALEJANDRINO
Practice Address - Street 2:VILLA CLEMENTINA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-402-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1492133V00000X
PR00941561133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered