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NPI 1295338242

NPI 1295338242 : ALEXANDER DANIEL RODRIGUEZ-DIAZ CRNA : HOLLYWOOD, FL

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General NPI Number Information
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    NPI Number           |    1295338242
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDER DANIEL RODRIGUEZ-DIAZ CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/20/2020
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    Last Update Date     |    03/31/2021
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Provider Practice Location Address
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    Address Line         |    3501 JOHNSON ST 
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    City                 |    HOLLYWOOD
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    State                |    FL
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    Zip                  |    33021-5421
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    Country              |    US
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    Telephone            |    954-987-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8241 DUNDEE TER 
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    City                 |    MIAMI LAKES
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    State                |    FL
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    Zip                  |    33016-1410
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    Country              |    US
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    Telephone            |    305-926-0724
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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        |    364S00000X
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    Taxonomy Name        |    Clinical Nurse Specialist
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    License Number       |    RN9394314
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    APRN11010853
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    License Number State |    FL
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