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General NPI Number Information
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NPI Number | 1457467672
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Entity Type | Individual
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Provider Name | GEORGETTE RODRIGUEZ MD
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 5600 SW 87TH ST
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City | MIAMI
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State | FL
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Zip | 33143-8315
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Country | US
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Telephone | 941-468-2719
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Fax | 305-663-1156
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Provider Business Mailing Address
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Address Line | 5600 SW 87TH ST
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City | MIAMI
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State | FL
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Zip | 33143-8315
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Country | US
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Telephone | 305-661-0093
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Fax | 305-663-1156
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME95752
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License Number State | FL
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