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General NPI Number Information
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NPI Number | 1215890579
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Entity Type | Individual
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Provider Name | WALTER RODRIGUEZ RN
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 6625 MIAMI LAKES DR STE 381
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2702
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Country | US
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Telephone | 786-708-0877
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Fax |
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Provider Business Mailing Address
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Address Line | 5890 W 14TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-6227
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Country | US
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Telephone | 305-305-9818
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN96440666
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License Number State | FL
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