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General NPI Number Information
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NPI Number | 1952251282
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Entity Type | Individual
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Provider Name | LUIS ALAN RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 660 S CORONADO DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-3386
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Country | US
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Telephone | 520-459-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 1753 N SAN SIMON DR
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City | NOGALES
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State | AZ
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Zip | 85621-4122
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Country | US
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Telephone | 520-223-3731
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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 |
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License Number State | AZ
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