Healthcare Provider Details

I. General information

NPI: 1568774750
Provider Name (Legal Business Name): PAOLA RODRIGUEZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 NW 5TH ST STE 107
PLANTATION FL
33317-1612
US

IV. Provider business mailing address

1502 BLUE JAY CIR
WESTON FL
33327-2006
US

V. Phone/Fax

Practice location:
  • Phone: 954-682-8000
  • Fax:
Mailing address:
  • Phone: 561-513-7913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31479.
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: