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General NPI Number Information
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NPI Number | 1417554304
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Entity Type | Individual
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Provider Name | MRS. DANA LYNN RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 2700 HEALING WAY STE 300
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5453
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Country | US
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Telephone | 813-333-1186
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Fax |
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Provider Business Mailing Address
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Address Line | 7427 ALAFIA RIDGE RD
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City | RIVERVIEW
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State | FL
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Zip | 33569-4705
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Country | US
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Telephone | 813-992-0030
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11008140
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License Number State | FL
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