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General NPI Number Information
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NPI Number | 1659049880
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Entity Type | Individual
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Provider Name | ROXANA RODRIGUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 21200 SAINT ANDREWS BLVD
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City | BOCA RATON
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State | FL
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Zip | 33433-2403
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Country | US
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Telephone | 561-571-7108
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Fax |
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Provider Business Mailing Address
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Address Line | 3383 NE 4TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-7129
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Country | US
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Telephone | 786-395-4122
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401417679
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 26764
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License Number State | FL
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