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General NPI Number Information
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NPI Number | 1841816279
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Entity Type | Individual
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Provider Name | YOAN ERNESTO RODRIGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 655 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-383-1013
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Fax | 904-244-2165
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Provider Business Mailing Address
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Address Line | 4925 COLLINS RD APT 3103
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City | JACKSONVILLE
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State | FL
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Zip | 32244-9541
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Country | US
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Telephone | 786-333-9091
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TRN36040
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License Number State | FL
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