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General NPI Number Information
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NPI Number | 1164715462
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Entity Type | Individual
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Provider Name | SANDRA RODRIGUEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 925 NE 30TH TER STE 204
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City | HOMESTEAD
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State | FL
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Zip | 33033-7614
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Country | US
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Telephone | 786-500-4644
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Fax | 786-530-6862
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Provider Business Mailing Address
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Address Line | 815 N HOMESTEAD BLVD UNIT 448
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City | HOMESTEAD
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State | FL
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Zip | 33030-5024
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Country | US
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Telephone | 786-500-4644
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Fax | 786-530-6862
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME132973
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License Number State | FL
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