Healthcare Provider Details

I. General information

NPI: 1447620091
Provider Name (Legal Business Name): CORINNE RODRIGUEZ RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 E VIRGINIA ST
TUCSON AZ
85706-3434
US

IV. Provider business mailing address

2221 E VIRGINIA ST
TUCSON AZ
85706-3434
US

V. Phone/Fax

Practice location:
  • Phone: 520-906-6771
  • Fax:
Mailing address:
  • Phone: 520-906-6771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number6120
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: