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General NPI Number Information
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NPI Number | 1093989352
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Entity Type | Individual
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Provider Name | ROXANNE RODRIGUEZ P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 12602 TOEPPERWEIN RD SUITE 100
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City | LIVE OAK
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State | TX
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Zip | 78233-3269
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Country | US
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Telephone | 210-654-0030
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Fax | 855-278-4550
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 400
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City | MIAMI
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State | FL
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Zip | 33126-2051
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Country | US
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Telephone | 305-500-2027
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Fax | 305-500-2155
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA05692
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License Number State | TX
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