Healthcare Provider Details

I. General information

NPI: 1679528871
Provider Name (Legal Business Name): LAURA RODRIGUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E ENID DR
KEY BISCAYNE FL
33149-2206
US

IV. Provider business mailing address

251 E ENID DR
KEY BISCAYNE FL
33149-2206
US

V. Phone/Fax

Practice location:
  • Phone: 305-361-8587
  • Fax: 305-361-8587
Mailing address:
  • Phone: 305-361-8587
  • Fax: 305-361-8587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME66804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: