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General NPI Number Information
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NPI Number | 1568860419
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Entity Type | Individual
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Provider Name | MAURICIO ENRIQUE RODRIGUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 5088 NW 74TH AVE
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City | MIAMI
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State | FL
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Zip | 33166-5551
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Country | US
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Telephone | 786-509-8350
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Fax | 786-633-3688
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Provider Business Mailing Address
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Address Line | 2813 EXECUTIVE PARK DR STE 126
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City | WESTON
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State | FL
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Zip | 33331-3603
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Country | US
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Telephone | 954-247-1557
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Fax |
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME129741
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License Number State | FL
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