MEDICARE: MELISSA 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	363LF0000X	Family Nurse Practitioner	NP95032410	CA

General Provider Information

NPI Number	:	1992520415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA RODRIGUEZ

Provider Business Mailing Address
First Line	:	7559 E 42ND PL
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85365-8458
Country	:	US
Telephone Number	:	928-503-7268
Fax Number	:

Provider Business Practice Location Address
First Line	:	2402 IMPERIAL BUSINESS PARK DR
Second Line	:
City	:	IMPERIAL
State	:	CA
Zip	:	92251-4004
Country	:	US
Telephone Number	:	760-355-5248
Fax Number	:

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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Directions to “ MELISSA RODRIGUEZ ” Practice Location

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