Healthcare Provider Details

I. General information

NPI: 1679408298
Provider Name (Legal Business Name): MARIA ISABELA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 NW NORTH RIVER DR APT 702
MIAMI FL
33125-2870
US

IV. Provider business mailing address

1480 NW NORTH RIVER DR APT 702
MIAMI FL
33125-2870
US

V. Phone/Fax

Practice location:
  • Phone: 901-830-3404
  • Fax:
Mailing address:
  • Phone: 901-830-3404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048384
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: