Healthcare Provider Details
I. General information
NPI: 1427148543
Provider Name (Legal Business Name): RUTH M RODRIGUEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2006
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13535 NEMOURS PKWY NEMOURS CHILDRENS HOSPITAL
ORLANDO FL
32827-7402
US
IV. Provider business mailing address
PO BOX 191 PROVIDER ENROLLMENT DEPARTMENT
ROCKLAND DE
19732-0191
US
V. Phone/Fax
- Phone: 407-567-3876
- Fax: 407-567-5924
- Phone: 302-651-5985
- Fax: 302-651-4945
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | TP346 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 06144 |
| License Number State | KY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 0102205369 |
| License Number State | VA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | OS6692 |
| License Number State | FL |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | OS6692 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: