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General NPI Number Information
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NPI Number | 1891662284
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Entity Type | Individual
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Provider Name | JORGE ANTONIO RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 731 NW 76TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6819
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Country | US
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Telephone | 754-347-3700
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Fax | 954-708-1005
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Provider Business Mailing Address
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Address Line | 731 NW 76TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6819
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Country | US
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Telephone | 754-347-3700
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Fax | 954-708-1005
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | FL
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