Provider Demographics
NPI:1336446046
Name:CLINICA MULTIDISCIPLINARIA DE DESARROLLO
Entity Type:Organization
Organization Name:CLINICA MULTIDISCIPLINARIA DE DESARROLLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-7213
Mailing Address - Street 1:114 CALLE GEORGETTI
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-3011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3011
Practice Address - Country:US
Practice Address - Phone:787-869-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty