Individual provider Active NPI

Maria D. Rodriguez Rosa, PSYD

  • Clinical Psychologist
  • Coamo, PR
National Provider Identifier
1033487400
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3812 Issued in PR
Practice address
Bo. Los Llanos Carr. 14 KM. 27.8
Coamo, PR 00769
Phone
(787) 929-5511
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3812 PR Primary

Addresses

Primary practice location

Bo. Los Llanos Carr. 14 KM. 27.8
Coamo, PR 00769

Mailing address

HC 1 Box 15781
Coamo, PR 00769-9756
Phone (787) 929-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000091 PR Practitioner - Clinical Psychologist 5698938363 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1033487400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 15781",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007699756",
            "telephone_number": "787-929-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO. LOS LLANOS CARR. 14 KM. 27.8",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "00769",
            "telephone_number": "787-929-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ ROSA",
        "first_name": "MARIA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

Verify at the official NPI Registry.