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General NPI Number Information
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NPI Number | 1669649521
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Entity Type | Individual
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Provider Name | VIMARIE RODRIGUEZ MD
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Gender | Female
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 7976 SEMINOLE BLVD STE 1
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City | SEMINOLE
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State | FL
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Zip | 33772-4899
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Country | US
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Telephone | 727-231-1800
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Fax | 727-231-1801
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Provider Business Mailing Address
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Address Line | 3251 N MCMULLEN BOOTH RD STE 303
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City | CLEARWATER
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State | FL
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Zip | 33761-2022
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Country | US
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Telephone | 727-725-6110
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Fax | 727-669-9742
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 016250
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME154829
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 036119539
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 092606
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License Number State | OH
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