Provider Demographics
NPI:1588332548
Name:RODAS, ROSA MARIA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:RODAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 JOSLIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-2534
Mailing Address - Country:US
Mailing Address - Phone:401-442-7156
Mailing Address - Fax:
Practice Address - Street 1:14 JOSLIN ST APT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-2534
Practice Address - Country:US
Practice Address - Phone:401-442-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI863982208376J00000X
RI0172162376J00000X
RI01721462376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker