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General NPI Number Information
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NPI Number | 1083894752
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Entity Type | Individual
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Provider Name | PHILIP RODRIGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 6035 SW 40TH ST STE 101
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City | MIAMI
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State | FL
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Zip | 33155-5200
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Country | US
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Telephone | 305-858-3096
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Fax | 305-858-7052
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Provider Business Mailing Address
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Address Line | 6035 SW 40TH ST STE 101
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City | MIAMI
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State | FL
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Zip | 33155-5200
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Country | US
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Telephone | 305-858-3096
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Fax | 305-858-7052
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0043026
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License Number State | FL
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