Healthcare Provider Details

I. General information

NPI: 1740221399
Provider Name (Legal Business Name): JOAQUIN RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 SW 107TH AVE
MIAMI FL
33165-7344
US

IV. Provider business mailing address

7452 W 32 ST
HIALEAH FL
33018-5214
US

V. Phone/Fax

Practice location:
  • Phone: 305-207-4443
  • Fax:
Mailing address:
  • Phone: 305-551-8485
  • Fax: 305-551-8486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME92694
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: