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General NPI Number Information
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NPI Number | 1821833617
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Entity Type | Individual
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Provider Name | ROBERTO JOSE RODRIGUEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 5130 LINTON BLVD STE E3
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6595
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Country | US
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Telephone | 561-763-5943
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Fax |
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Provider Business Mailing Address
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Address Line | 51 NE 46TH ST
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1543
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Country | US
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Telephone | 813-493-2527
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN29181
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License Number State | FL
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