Provider Demographics
NPI:1962026245
Name:RODRIGUEZ, KARLA M
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:M
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 1:23 CALLE JOSE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2117
Mailing Address - Country:US
Mailing Address - Phone:787-221-4039
Mailing Address - Fax:
Practice Address - Street 1:23 CALLE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2117
Practice Address - Country:US
Practice Address - Phone:787-221-4039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR66-093-4053OtherPRIVATE HEALTH INSURANCE