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NPI Code Detail

MEDICARE: MR. RICARDO ARTURO RODRIGUEZ

MEDICARE: MR. RICARDO ARTURO RODRIGUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2235Z00000XSpeech-Language Pathologist7101004721MI

General Provider Information

NPI Number : 1073857843
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICARDO ARTURO RODRIGUEZ
Provider Business Mailing Address
First Line : 22415 CHESTNUT TREE
Second Line :
City : NOVI
State : MI
Zip : 48375-4307
Country : US
Telephone Number : 810-210-1688
Fax Number :
Provider Business Practice Location Address
First Line : 26505 POWERS AVE
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-1327
Country : US
Telephone Number : 313-291-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2012
Last Update Date : 12/07/2018

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