Provider Demographics
NPI:1700127180
Name:RODRIGUEZ, MAGDA IRIS (PT)
Entity type:Individual
Prefix:MRS
First Name:MAGDA
Middle Name:IRIS
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CALLE BELEN
Mailing Address - Street 2:BARRIADA SAN LUIS
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3113
Mailing Address - Country:US
Mailing Address - Phone:787-614-4009
Mailing Address - Fax:
Practice Address - Street 1:9 CALLE BELEN
Practice Address - Street 2:BARRIADA SAN LUIS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3113
Practice Address - Country:US
Practice Address - Phone:787-614-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist