Provider Demographics
NPI:1871994384
Name:RODRIGUEZ-ACEVEDO, LIZA (MS-SLP)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:RODRIGUEZ-ACEVEDO
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRO PEDIATRICO METROPOLITANO, HOSPITAL PEDIATRICO
Mailing Address - Street 2:CALL BOX 191079
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1079
Mailing Address - Country:US
Mailing Address - Phone:787-763-0550
Mailing Address - Fax:787-763-1093
Practice Address - Street 1:CENTRO PEDIATRICO METROPOLITANO, HOSPITAL PEDIATRICO
Practice Address - Street 2:CALL BOX 191079
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-1079
Practice Address - Country:US
Practice Address - Phone:787-763-0550
Practice Address - Fax:787-763-1093
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist