=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477729846
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MANUEL RODRIGUEZ D.P.M.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2008
-----------------------------------------------------
Last Update Date | 01/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7001 SW 61ST AVE
-----------------------------------------------------
City | SOUTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33143-3420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-662-1444
-----------------------------------------------------
Fax | 305-667-6086
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7001 SW 61ST AVE
-----------------------------------------------------
City | SOUTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33143-3420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-662-1444
-----------------------------------------------------
Fax | 305-667-6086
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | PO 3312
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------