Healthcare Provider Details

I. General information

NPI: 1477729846
Provider Name (Legal Business Name): MANUEL RODRIGUEZ D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

IV. Provider business mailing address

7001 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

V. Phone/Fax

Practice location:
  • Phone: 305-662-1444
  • Fax: 305-667-6086
Mailing address:
  • Phone: 305-662-1444
  • Fax: 305-667-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 3312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: