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General NPI Number Information
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NPI Number | 1861780694
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Entity Type | Organization
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Legal Business Name | YANITZA RODRIGUEZ MD PA
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 5350 10TH AVE N STE 1
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City | GREENACRES
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State | FL
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Zip | 33463-2071
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Country | US
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Telephone | 678-446-0729
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Fax | 561-793-2583
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Provider Business Mailing Address
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Address Line | 5350 10TH AVE N STE 1
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City | GREENACRES
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State | FL
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Zip | 33463-2071
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Country | US
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Telephone | 678-446-0729
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Fax | 561-793-2583
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YANITZA RODRIGUEZ
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Credential | MD
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Telephone | 770-380-3498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME 107763
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License Number State | FL
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