Healthcare Provider Details

I. General information

NPI: 1669338489
Provider Name (Legal Business Name): ROSALINDA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 MOORES RIVER DR
LANSING MI
48910-1434
US

IV. Provider business mailing address

1025 CADY CT
LANSING MI
48906-5402
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-0226
  • Fax: 517-887-8121
Mailing address:
  • Phone: 989-598-1195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: