Provider Demographics
NPI:1861799835
Name:RODRIGUEZ, JUANITA R (RN)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:R
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEONOR
Other - Middle Name:
Other - Last Name:ROBLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3316 MONCLOVA DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-8787
Mailing Address - Country:US
Mailing Address - Phone:956-726-9930
Mailing Address - Fax:956-726-9935
Practice Address - Street 1:3316 MONCLOVA DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-8787
Practice Address - Country:US
Practice Address - Phone:956-726-9930
Practice Address - Fax:956-726-9935
Is Sole Proprietor?:No
Enumeration Date:2011-02-27
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578305163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator