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General NPI Number Information
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NPI Number | 1295154094
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Entity Type | Individual
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Provider Name | HERIBERTO RODRIGUEZ HERNANDEZ NP
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 175 FOUNTAINBLEAU BLVD STE 1F
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City | MIAMI
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State | FL
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Zip | 33172-4511
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Country | US
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Telephone | 786-389-8242
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Fax |
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Provider Business Mailing Address
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Address Line | 175 FOUNTAINBLEAU BLVD STE 1F
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City | MIAMI
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State | FL
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Zip | 33172-4511
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Country | US
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Telephone | 786-389-8242
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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 | 645037
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07201323
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11010128
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License Number State | FL
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