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General NPI Number Information
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NPI Number | 1699194092
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Entity Type | Individual
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Provider Name | VICTOR RODRIGUEZ DDS, CAGS
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Gender | Male
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 2000 NW 87TH AVE STE 215
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City | DORAL
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State | FL
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Zip | 33172-2657
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Country | US
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Telephone | 786-953-6550
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Fax | 786-431-5918
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Provider Business Mailing Address
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Address Line | 2000 NW 87TH AVE STE 215
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City | DORAL
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State | FL
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Zip | 33172-2657
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Country | US
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Telephone | 786-953-6550
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Fax | 786-431-5918
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | DN21843
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21843
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License Number State | FL
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