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General NPI Number Information
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NPI Number | 1386744845
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Entity Type | Individual
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Provider Name | HERMINIA D. RODRIGUEZ D.M.D., P.A.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/26/2017
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Provider Practice Location Address
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Address Line | 1640 S VOLUSIA AVE
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City | ORANGE CITY
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State | FL
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Zip | 32763-7335
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Country | US
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Telephone | 386-775-4911
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 S VOLUSIA AVE
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City | ORANGE CITY
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State | FL
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Zip | 32763-7335
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Country | US
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Telephone | 386-775-4911
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Fax | 386-775-6229
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN10606
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License Number State | FL
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