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General NPI Number Information
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NPI Number | 1700157906
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Entity Type | Organization
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Legal Business Name | JESUS S RODRIGUEZ, M.D. P.A.
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 142 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1853
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Country | US
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Telephone | 305-822-1993
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Fax | 305-826-3788
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Provider Business Mailing Address
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Address Line | 142 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1853
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Country | US
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Telephone | 305-822-1993
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Fax | 305-826-3788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESUS SILVESTRE RODRIGUEZ
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Credential | M.D.
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Telephone | 305-822-1993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0033464
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License Number State | FL
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