Provider Demographics
NPI:1982802617
Name:RODRIGUEZ, MARIA L (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1787
Mailing Address - Country:US
Mailing Address - Phone:808-691-8511
Mailing Address - Fax:808-623-2059
Practice Address - Street 1:95-1249 MEHEULA PKWY STE 129
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1787
Practice Address - Country:US
Practice Address - Phone:808-691-8511
Practice Address - Fax:808-623-2059
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD18148207Q00000X
NH14044207Q00000X
HIMD-21938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI001722Medicaid
ME1982802617Medicaid
NH3075130Medicaid
NHP00673148OtherRR MEDICARE