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NPI Code Detail

MEDICARE: ERNESTO RODRIGUEZ

MEDICARE:   ERNESTO  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
1247200000XOther Technician2104708564NV

General Provider Information

NPI Number : 1316314529
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNESTO RODRIGUEZ
Provider Business Mailing Address
First Line : 5143 TITANIUM CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1644
Country : US
Telephone Number : 702-409-9043
Fax Number :
Provider Business Practice Location Address
First Line : 5143 TITANIUM CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1644
Country : US
Telephone Number : 702-409-9043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2015
Last Update Date : 08/24/2015

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Directions to “ ERNESTO RODRIGUEZ ” Practice Location

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