MEDICARE: HUGO GUILLERMO 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
1	122300000X	Dentist	31004	FL

General Provider Information

NPI Number	:	1528864634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUGO GUILLERMO RODRIGUEZ

Provider Business Mailing Address
First Line	:	860 SANCTUARY COVE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-4523
Country	:	US
Telephone Number	:	310-980-5933
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 SANCTUARY COVE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-4523
Country	:	US
Telephone Number	:	310-980-5933
Fax Number	:

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

Provider Enumeration Date	:	02/20/2025
Last Update Date	:	09/23/2025

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