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General NPI Number Information
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NPI Number | 1700699915
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Entity Type | Organization
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Legal Business Name | LISET RODRIGUEZ OD PLLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 5372 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-2165
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Country | US
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Telephone | 305-362-4020
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Fax | 305-362-2592
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Provider Business Mailing Address
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Address Line | 1680 W 56TH ST APT C223
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City | HIALEAH
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State | FL
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Zip | 33012-2048
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Country | US
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Telephone | 305-904-5656
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISET RODRIGUES
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Credential | DO
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Telephone | 305-904-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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