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NPI Code Detail

MEDICARE: JAIME J RODRIGUEZ MD INC

MEDICARE: JAIME J RODRIGUEZ MD INC
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
1207V00000XObstetrics & Gynecology Physician
2207VM0101XMaternal & Fetal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
238634OTHERFLBCBS

General Provider Information

NPI Number : 1184606212
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAIME J RODRIGUEZ MD INC
Provider Business Mailing Address
First Line : PO BOX 817087
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33081-1087
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4105 PEMBROKE RD
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-8103
Country : US
Telephone Number : 954-985-1551
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : KATHLEEN KONDAS
Credential :
Telephone Number : 954-838-2371
Provider Enumeration Date : 11/15/2005
Last Update Date : 09/19/2019

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