MEDICARE: DR. ORLANDO CHARRY-RODRIQUEZ 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
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	43284	MN
2	208100000X	Physical Medicine & Rehabilitation Physician	43284	MN

General Provider Information

NPI Number	:	1518931187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ORLANDO CHARRY-RODRIQUEZ MD

Provider Business Mailing Address
First Line	:	606 24TH AVE S
Second Line	:	606
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 E 26TH ST STE 503
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-4515
Country	:	US
Telephone Number	:	612-863-5100
Fax Number	:	612-863-5109

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	11/10/2020

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