Healthcare Provider Details

I. General information

NPI: 1558892950
Provider Name (Legal Business Name): SEBASTIAN RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

IV. Provider business mailing address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-8300
  • Fax: 717-544-8265
Mailing address:
  • Phone: 717-544-8300
  • Fax: 717-544-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD470154
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: