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General NPI Number Information
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NPI Number | 1699622142
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Entity Type | Individual
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Provider Name | BETHZAIDA PEREZ RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 485 S RONALD REAGAN BLVD
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City | LONGWOOD
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State | FL
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Zip | 32750-5408
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Country | US
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Telephone | 407-834-4849
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 SEMINOLA BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-3523
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Country | US
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Telephone | 407-535-5291
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN9296856
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License Number State | FL
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