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NPI Code Detail

MEDICARE: THALIA RODRIGUEZ

MEDICARE:   THALIA  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
1122300000XDentistDN31920FL

General Provider Information

NPI Number : 1164361127
Entity Type Code : Individual
Provider Name (Legal Business Name) : THALIA RODRIGUEZ
Provider Business Mailing Address
First Line : 1529 WALNUT ST APT 502
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-3012
Country : US
Telephone Number : 305-316-4960
Fax Number :
Provider Business Practice Location Address
First Line : 6216 E SLIGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-9105
Country : US
Telephone Number : 813-397-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 06/17/2026

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Directions to “ THALIA RODRIGUEZ ” Practice Location

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