Healthcare Provider Details

I. General information

NPI: 1003438870
Provider Name (Legal Business Name): AARON RODAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 ERNSTON RD
SOUTH AMBOY NJ
08879-2000
US

IV. Provider business mailing address

17350 NW 68TH AVE, BUILDING 300, UNIT 416
HIALEAH FL
33015
US

V. Phone/Fax

Practice location:
  • Phone: 732-585-1815
  • Fax:
Mailing address:
  • Phone: 201-877-2860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12161400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME162789
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD479176
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number341177
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: