Provider Demographics
NPI:1013502731
Name:RODRIGUEZ, MERARY
Entity Type:Individual
Prefix:MISS
First Name:MERARY
Middle Name:
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:PROGRAMA DE SALUD DE PERSONAS SIN HOGAR PO BOX 21405
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR-PUERTO RICO
Mailing Address - Zip Code:00928
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE CERRA #900
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR - PUERTO RICO
Practice Address - Zip Code:00907
Practice Address - Country:UM
Practice Address - Phone:787-444-5583
Practice Address - Fax:787-723-6247
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92692251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care