Healthcare Provider Details

I. General information

NPI: 1811425598
Provider Name (Legal Business Name): ARIAN RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13611 SW 260TH LN
HOMESTEAD FL
33032
US

IV. Provider business mailing address

13611 SW 260 TH LN
HOMESTEAD FL
33032
US

V. Phone/Fax

Practice location:
  • Phone: 786-397-9062
  • Fax:
Mailing address:
  • Phone: 786-397-9062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT13954
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: