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General NPI Number Information
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NPI Number | 1336512946
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Entity Type | Individual
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Provider Name | ILIANNIE RODRIGUEZ CHALUISANT MD
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Gender | Female
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1490 SE MAGNOLIA EXT
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City | OCALA
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State | FL
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Zip | 34471-4443
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Country | US
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Telephone | 352-351-7200
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Fax | 352-671-4393
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Provider Business Mailing Address
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Address Line | PO BOX 21643
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City | TAMPA
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State | FL
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Zip | 33622-1643
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Country | US
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Telephone | 352-671-4300
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Fax | 352-671-4393
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 99186
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME145985
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License Number State | FL
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