Healthcare Provider Details

I. General information

NPI: 1083538128
Provider Name (Legal Business Name): ALEXIS RODRIGUEZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 NE 30TH ST APT 406
MIAMI FL
33137-4382
US

IV. Provider business mailing address

479 NE 30TH ST APT 406
MIAMI FL
33137-4382
US

V. Phone/Fax

Practice location:
  • Phone: 305-439-7651
  • Fax:
Mailing address:
  • Phone: 305-439-7651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9564826
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: