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General NPI Number Information
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NPI Number | 1427343953
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Entity Type | Individual
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Provider Name | ROBERT SNYDER RODRIGUEZ PA
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Gender | Male
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 1100 F AVE
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City | DOUGLAS
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State | AZ
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Zip | 85607-1919
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Country | US
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Telephone | 520-364-3285
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Fax | 520-364-4261
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Provider Business Mailing Address
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Address Line | 1205 F AVE
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City | DOUGLAS
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State | AZ
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Zip | 85607-1920
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Country | US
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Telephone | 520-364-1429
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Fax | 520-364-4261
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4915
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License Number State | AZ
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