Healthcare Provider Details

I. General information

NPI: 1053271916
Provider Name (Legal Business Name): ROSARIO LOURDES RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3982 VAIL CT
LOVELAND CO
80538-5597
US

IV. Provider business mailing address

3982 VAIL CT
LOVELAND CO
80538-5597
US

V. Phone/Fax

Practice location:
  • Phone: 970-301-9640
  • Fax: 970-775-2652
Mailing address:
  • Phone: 970-301-9640
  • Fax: 970-775-2652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: