Healthcare Provider Details

I. General information

NPI: 1356331995
Provider Name (Legal Business Name): DANIEL HECTOR RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 LITTLE RD
TRINITY FL
34655
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 727-375-1548
  • Fax: 727-375-1557
Mailing address:
  • Phone: 352-567-0188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME81923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: