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General NPI Number Information
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NPI Number | 1568782464
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PRIMARY CARE LLC
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 7495 NORTH UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321
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Country | US
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Telephone | 954-722-2302
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Fax | 954-428-4909
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Provider Business Mailing Address
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Address Line | 7495 NORTH UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321
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Country | US
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Telephone | 954-722-2302
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Fax | 954-428-4909
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID R RODRIGUEZ
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Credential |
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Telephone | 786-417-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | OS7334
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License Number State | FL
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