Healthcare Provider Details

I. General information

NPI: 1902976186
Provider Name (Legal Business Name): HUBERT ALFREDO RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 9TH AVE SW SUITE 100
BESSEMER AL
35022-4530
US

IV. Provider business mailing address

1090 9TH AVE SW SUITE 100
BESSEMER AL
35022-4530
US

V. Phone/Fax

Practice location:
  • Phone: 205-481-1886
  • Fax: 205-481-9034
Mailing address:
  • Phone: 205-481-1886
  • Fax: 205-481-9034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7220
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: