Provider Demographics
NPI:1699900357
Name:RODRIGUEZ, IVETTE (MSN, WCNS)
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSN, WCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 7 F-32 TURABO GARDENS
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-223-6989
Mailing Address - Fax:
Practice Address - Street 1:CALLE J.R GARZOT #33 LOCAL #2
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718
Practice Address - Country:US
Practice Address - Phone:787-649-4967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR187163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care