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General NPI Number Information
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NPI Number | 1154709780
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Entity Type | Individual
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Provider Name | MELANIE ANN RODRIGUEZ PA
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Gender | Female
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 1300 PEACHTREE INDUSTRIAL BLVD STE 4101
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City | SUWANEE
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State | GA
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Zip | 30024-4542
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Country | US
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Telephone | 770-831-5525
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 PEACHTREE INDUSTRIAL BLVD STE 4101
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City | SUWANEE
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State | GA
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Zip | 30024-4542
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Country | US
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Telephone | 770-831-5525
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9112074
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA6038
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12678
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License Number State | GA
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