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General NPI Number Information
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NPI Number | 1386983641
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Entity Type | Individual
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Provider Name | JOSE MANUEL RODRIGUEZ PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 4641 CASON COVE DR UNIT # 2112
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City | ORLANDO
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State | FL
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Zip | 32811-7429
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Country | US
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Telephone | 787-420-4084
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Fax |
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Provider Business Mailing Address
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Address Line | 4641 CASON COVE DR UNIT # 2112
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City | ORLANDO
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State | FL
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Zip | 32811-7429
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Country | US
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Telephone | 787-420-4084
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4829
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9340346
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 19641
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License Number State | PR
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