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General NPI Number Information
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NPI Number | 1669057337
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Entity Type | Individual
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Provider Name | OMAYSA RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 5301 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2269
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Country | US
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Telephone | 786-953-8225
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2269
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Country | US
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Telephone |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 854087321
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License Number State | FL
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