Healthcare Provider Details

I. General information

NPI: 1093626889
Provider Name (Legal Business Name): ANDREA CAMIL RODRIGUEZ INFANZON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDREA RODRIGUEZ L.AC

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17045 S DIXIE HWY
PALMETTO BAY FL
33157-4362
US

IV. Provider business mailing address

15857 SW 141ST TER
MIAMI FL
33196-6724
US

V. Phone/Fax

Practice location:
  • Phone: 305-232-2200
  • Fax:
Mailing address:
  • Phone: 787-702-0996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: