Healthcare Provider Details

I. General information

NPI: 1699608836
Provider Name (Legal Business Name): MARISOL RODRIGUEZ RIGAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5461 NW 95TH AVE
SUNRISE FL
33351-7711
US

IV. Provider business mailing address

5461 NW 95TH AVE
SUNRISE FL
33351-7711
US

V. Phone/Fax

Practice location:
  • Phone: 786-366-0474
  • Fax:
Mailing address:
  • Phone: 786-366-0474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31766
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: