Healthcare Provider Details

I. General information

NPI: 1497442933
Provider Name (Legal Business Name): MARIAN RODRIGUEZ-CARBO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5406 LITTLE RD
NEW PORT RICHEY FL
34655-1103
US

IV. Provider business mailing address

17 DAVIS BLVD STE 308
TAMPA FL
33606-3438
US

V. Phone/Fax

Practice location:
  • Phone: 727-748-0330
  • Fax: 727-748-0533
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME175542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: