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General NPI Number Information
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NPI Number | 1548558349
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Entity Type | Individual
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Provider Name | MARITESS LAURENTE RODRIGUEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 601 E ROLLINS ST
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-667-0444
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Fax | 407-667-4338
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Provider Business Mailing Address
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Address Line | 291 SOUTHHALL LN SUITE 201
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City | MAITLAND
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State | FL
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Zip | 32751-7274
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Country | US
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Telephone | 407-667-0444
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Fax | 407-667-4338
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP3034562
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 6046
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License Number State | NC
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