MEDICARE: YUDAMIS 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	246Z00000X	Other Specialist/Technologist		SC

General Provider Information

NPI Number	:	1699644468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUDAMIS RODRIGUEZ

Provider Business Mailing Address
First Line	:	1118 AUTUMN CIR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-4986
Country	:	US
Telephone Number	:	803-751-0208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 AUTUMN CIR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-4986
Country	:	US
Telephone Number	:	803-751-0208
Fax Number	:

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

Provider Enumeration Date	:	10/31/2025
Last Update Date	:	10/31/2025

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Directions to “ YUDAMIS RODRIGUEZ ” Practice Location

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