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General NPI Number Information
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NPI Number | 1881603900
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Entity Type | Organization
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Legal Business Name | PAUL A RODRIGUEZ DO PA
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 1821 NE 25TH ST SUITE 100
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-7744
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Country | US
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Telephone | 954-941-0484
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Fax | 954-941-0485
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Provider Business Mailing Address
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Address Line | 1821 NE 25TH STREET SUITE 100
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064
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Country | US
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Telephone | 954-941-0484
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Fax | 954-941-0485
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Authorized Official
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Title or Position | DIRECTOR, PRESIDENT,SECRETARY,TREAS
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Name | PAUL A RODRIGUEZ
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Credential | D.O., P.A.
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Telephone | 954-941-0484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS7048
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License Number State | FL
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