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General NPI Number Information
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NPI Number | 1568475945
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Entity Type | Organization
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Legal Business Name | IGNACIO RODRIGUEZ MD PA
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 4850 W OAKLAND PARK BLVD SUITE 102
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-7260
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Country | US
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Telephone | 954-486-4180
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Fax | 954-486-6688
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Provider Business Mailing Address
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Address Line | 4850 W OAKLAND PARK BLVD SUITE 102
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-7260
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Country | US
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Telephone | 954-486-4180
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Fax | 954-486-6688
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IGNACIO RODRIGUEZ
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Credential | M.D.
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Telephone | 954-486-4180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME042334
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License Number State | FL
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