MEDICARE: ZADIA Y RODRIGUEZ RDN

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
1	133V00000X	Registered Dietitian	1192	PR

General Provider Information

NPI Number	:	1598399446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZADIA Y RODRIGUEZ RDN

Provider Business Mailing Address
First Line	:	HC 2 BOX 4118
Second Line	:
City	:	COAMO
State	:	PR
Zip	:	00769-9673
Country	:	US
Telephone Number	:	787-376-0641
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. CONSTANCIA 2706
Second Line	:	AVE. LAS AMERICAS
City	:	PONCE
State	:	PR
Zip	:	00717
Country	:	US
Telephone Number	:	787-806-5518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2020
Last Update Date	:	05/08/2020

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