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General NPI Number Information
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NPI Number | 1528459583
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Entity Type | Individual
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Provider Name | LISSETE RODRIGUEZ APRN
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 750 SE 3RD AVE STE 100
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-1153
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Country | US
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Telephone | 954-737-0273
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Fax | 954-761-2223
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Provider Business Mailing Address
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Address Line | 6255 W SUNSET BLVD FL 21
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City | LOS ANGELES
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State | CA
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Zip | 90028-7422
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Country | US
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Telephone | 323-860-5200
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Fax | 323-467-7119
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9389542
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9389542
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License Number State | FL
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