Healthcare Provider Details

I. General information

NPI: 1235390394
Provider Name (Legal Business Name): JENNIFER RODRIGUEZ-FERRER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2008
Last Update Date: 06/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 ALTON RD APT. PH 3310
MIAMI BEACH FL
33139-6707
US

IV. Provider business mailing address

90 ALTON RD APT. PH 3310
MIAMI BEACH FL
33139-6707
US

V. Phone/Fax

Practice location:
  • Phone: 917-621-7076
  • Fax: 305-722-3625
Mailing address:
  • Phone: 917-621-7076
  • Fax: 305-722-3625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberME101154
License Number StateFL

VIII. Authorized Official

Name: JENNIFER RODRIGUEZ-FERRER
Title or Position: PRESIDENT
Credential: MD
Phone: 917-621-7076