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General NPI Number Information
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NPI Number | 1982679726
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Entity Type | Individual
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Provider Name | NITZA RODRIGUEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | COLISEO SHOPPING CENTER - AVENIDA EDUARDO RUBERTE SUITE 103
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City | PONCE
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State | PR
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Zip | 00728-1712
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Country | US
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Telephone | 787-840-9708
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Fax | 787-840-9708
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Provider Business Mailing Address
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Address Line | MANUEL CHELO ROMAN ST # 48
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City | ADJUNTAS
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State | PR
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Zip | 00601
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Country | US
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Telephone | 787-391-8076
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Fax | 787-840-9708
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13924
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License Number State | PR
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