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NPI Code Detail

MEDICARE: WANDA IVELISSE RODRIGUEZ RN

MEDICARE: WANDA IVELISSE RODRIGUEZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA2000XAdministrator Registered Nurse013573PR

General Provider Information

NPI Number : 1528047685
Entity Type Code : Individual
Provider Name (Legal Business Name) : WANDA IVELISSE RODRIGUEZ RN
Provider Business Mailing Address
First Line : PSC 827 BOX 326
Second Line :
City : FPO
State : AE
Zip : 09617
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : U. S. NAVAL HOSPITAL NAPLES
Second Line : VIA CONTRADA BOSCARIELLO
City : GRICIGNANO
State : DI AVERSA CE
Zip : 81030
Country : IT
Telephone Number : 011390818116445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 04/20/2008

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