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NPI Code Detail

MEDICARE: DR. ANGELA MARIA RODRIGUEZ MD

MEDICARE:  DR. ANGELA MARIA RODRIGUEZ  MD
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
1207Q00000XFamily Medicine PhysicianME103196FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00769977OTHERFLRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1265633903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA MARIA RODRIGUEZ MD
Provider Business Mailing Address
First Line : PO BOX 11892
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33339-1892
Country : US
Telephone Number : 954-542-5832
Fax Number : 954-351-1571
Provider Business Practice Location Address
First Line : 1330 RIVERLAND RD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-2961
Country : US
Telephone Number : 954-321-9826
Fax Number : 954-321-9660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 09/17/2019

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