Healthcare Provider Details

I. General information

NPI: 1942307186
Provider Name (Legal Business Name): FRANCISCO RAMON RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 W ATLANTIC BLVD STE 102
MARGATE FL
33063-5157
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 954-869-4525
  • Fax: 954-869-4530
Mailing address:
  • Phone: 954-363-9582
  • Fax: 954-363-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberACN1305
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: