Healthcare Provider Details

I. General information

NPI: 1548467657
Provider Name (Legal Business Name): JOSE RODRIGUEZ-FELIZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE #903E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

8940 N KENDALL DR SUITE #903E
MIAMI FL
33176-2148
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-2969
  • Fax:
Mailing address:
  • Phone: 305-595-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME121347
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number071277
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: