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General NPI Number Information
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NPI Number | 1053072009
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Entity Type | Organization
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Legal Business Name | VICKY RODRIGUEZ DDS PA
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 177 SW 42 AVENUE
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City | MIAMI
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State | FL
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Zip | 33134
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Country | US
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Telephone | 305-445-8459
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Fax | 305-444-0337
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Provider Business Mailing Address
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Address Line | 177 SW 42 AVENUE
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City | MIAMI
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State | FL
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Zip | 33134
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Country | US
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Telephone | 305-445-8459
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Fax | 305-444-0337
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | VICKY RODRIGUEZ
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Credential | DDS
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Telephone | 305-445-8459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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