Healthcare Provider Details

I. General information

NPI: 1457844680
Provider Name (Legal Business Name): NATALIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 W SUNRISE BLVD
PLANTATION FL
33322-4113
US

IV. Provider business mailing address

1050 SW 3RD ST
HALLANDALE BEACH FL
33009-6149
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5254
  • Fax:
Mailing address:
  • Phone: 954-324-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9294280
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: