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General NPI Number Information
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NPI Number | 1376733683
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Entity Type | Organization
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Legal Business Name | RODOLFO L DY MD PA
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 14100 FIVAY ROAD SUITE 130
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City | HUDSON
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State | FL
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Zip | 34667-7159
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Country | US
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Telephone | 727-863-0034
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Fax | 727-869-9465
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Provider Business Mailing Address
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Address Line | 14100 FIVAY ROAD SUITE 130
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City | HUDSON
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State | FL
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Zip | 34667-7159
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Country | US
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Telephone | 727-863-0034
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Fax | 727-869-9465
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODOLFO LAUIGAN DY
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Credential | M.D.
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Telephone | 727-863-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME004985
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License Number State | FL
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