MEDICARE: DR. JESUS MANUEL RODRIGUEZ 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	208D00000X	General Practice Physician	ACN516	FL
2	208D00000X	General Practice Physician	14396	PR

General Provider Information

NPI Number	:	1841214996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESUS MANUEL RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	1260 NE 8TH ST STE 109
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-3169
Country	:	US
Telephone Number	:	239-539-6089
Fax Number	:	239-539-6079

Provider Business Practice Location Address
First Line	:	1260 NE 8TH ST STE 109
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-3169
Country	:	US
Telephone Number	:	239-539-6089
Fax Number	:	239-539-6079

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/27/2026

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