Healthcare Provider Details

I. General information

NPI: 1659205110
Provider Name (Legal Business Name): EBR HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9143 PANZANI PL
WINDERMERE FL
34786-8137
US

IV. Provider business mailing address

9143 PANZANI PL
WINDERMERE FL
34786-8137
US

V. Phone/Fax

Practice location:
  • Phone: 863-602-9134
  • Fax:
Mailing address:
  • Phone: 863-602-9134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAQUEL RODRIGUEZ
Title or Position: PRESIDENT AND MANAGING MEMBER
Credential: MD
Phone: 863-602-9134