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General NPI Number Information
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NPI Number | 1689965956
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Entity Type | Organization
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Legal Business Name | PHILIP RODRIGUEZ MD PA
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1616 S BAYSHORE DR
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City | MIAMI
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State | FL
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Zip | 33133-4202
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Country | US
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Telephone | 305-858-3096
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Fax | 305-858-7052
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Provider Business Mailing Address
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Address Line | 1616 S BAYSHORE DR
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City | MIAMI
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State | FL
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Zip | 33133-4202
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Country | US
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Telephone | 305-858-3096
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Fax | 305-858-7052
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILIP RODRIGUEZ
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Credential | MD
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Telephone | 306-858-3096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 38936500128250
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License Number State | FL
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