Healthcare Provider Details

I. General information

NPI: 1649190455
Provider Name (Legal Business Name): JOSE ORLANDO RODRIGUEZ DIAZ FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 S DOUGLAS RD
CORAL GABLES FL
33134-6183
US

IV. Provider business mailing address

5211 SW 139TH AVENUE RD
MIAMI FL
33175-5123
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-7070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049314
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: