Healthcare Provider Details

I. General information

NPI: 1386385011
Provider Name (Legal Business Name): JOSE LUIS RODRIGUEZ CASTRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 03/24/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 CLEVELAND CLINIC BLVD.
WESTON FL
33331
US

IV. Provider business mailing address

20900 BISCAYNE BLVD
MIAMI FL
33180-1407
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone: 305-682-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number34684
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: