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General NPI Number Information
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NPI Number | 1184147456
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Entity Type | Individual
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Provider Name | STEPHANIE RODRIGUEZ APRN
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 3499 W 4TH AVE STE 201
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City | HIALEAH
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State | FL
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Zip | 33012-4333
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Country | US
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Telephone | 305-558-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 71 E 58TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1241
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Country | US
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Telephone | 305-333-4793
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11015948
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN9373249
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License Number State | FL
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