Healthcare Provider Details

I. General information

NPI: 1699691832
Provider Name (Legal Business Name): DR. CHRISTIAN RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21200 SAINT ANDREWS BLVD STE 15
BOCA RATON FL
33433-2403
US

IV. Provider business mailing address

21200 SAINT ANDREWS BLVD STE 15
BOCA RATON FL
33433-2403
US

V. Phone/Fax

Practice location:
  • Phone: 561-571-7108
  • Fax: 561-584-8162
Mailing address:
  • Phone: 561-571-7108
  • Fax: 561-584-8162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: