Provider Demographics
NPI:1285818302
Name:PEREZ RODRIGUEZ, DELVA (MS)
Entity type:Individual
Prefix:MISS
First Name:DELVA
Middle Name:
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-0552
Mailing Address - Country:US
Mailing Address - Phone:787-883-1772
Mailing Address - Fax:
Practice Address - Street 1:CALLE DE LEON FINAL 296
Practice Address - Street 2:BUEN CONSEJO
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-883-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14720104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker