=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164358263
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PEDRO JESUS ALONSO RODRIGUEZ APRN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2026
-----------------------------------------------------
Last Update Date | 06/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5539 SW 8TH ST
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2266
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-833-0053
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15595 SW 57TH ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33193-2513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-728-3379
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN11048577
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------