MEDICARE: MRS. REYNA YOLANDA RODRIGUEZ P.A.

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
1	363A00000X	Physician Assistant	PA 9100749	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1407159023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REYNA YOLANDA RODRIGUEZ P.A.

Provider Business Mailing Address
First Line	:	PO BOX 278004
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-8004
Country	:	US
Telephone Number	:	305-231-8996
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 E 25TH ST STE 304
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3849
Country	:	US
Telephone Number	:	305-231-8996
Fax Number	:	305-231-8433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2010
Last Update Date	:	02/20/2024

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