Provider Demographics
NPI:1104408640
Name:RODRIGUEZ, ZOILA MARGARITA (RN)
Entity type:Individual
Prefix:
First Name:ZOILA
Middle Name:MARGARITA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ZOILA
Other - Middle Name:MARGARITA
Other - Last Name:DOINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 403
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-0403
Mailing Address - Country:US
Mailing Address - Phone:631-805-0405
Mailing Address - Fax:
Practice Address - Street 1:63 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1624
Practice Address - Country:US
Practice Address - Phone:631-805-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8113353163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty