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General NPI Number Information
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NPI Number | 1043804008
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Entity Type | Individual
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Provider Name | MARIALY RODRIGUEZ HERNANDEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2021
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1425 VISCAYA PKWY STE 205
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City | CAPE CORAL
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State | FL
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Zip | 33990-3294
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Country | US
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Telephone | 239-471-7407
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Fax | 239-673-1378
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Provider Business Mailing Address
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Address Line | 2809 SW 8TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33914-4204
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Country | US
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Telephone | 786-564-6050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11011690
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License Number State | FL
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