Provider Demographics
NPI:1174384432
Name:VECCHINI RODRIGUEZ, CLARA MARIA
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:MARIA
Last Name:VECCHINI RODRIGUEZ
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 1:1030 CALLE 5
Mailing Address - Street 2:URBANIZACION VILLA NEVAREZ
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5122
Mailing Address - Country:US
Mailing Address - Phone:787-477-5537
Mailing Address - Fax:
Practice Address - Street 1:1030 CALLE 5
Practice Address - Street 2:URBANIZACION VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5122
Practice Address - Country:US
Practice Address - Phone:787-477-5537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3045390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program