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General NPI Number Information
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NPI Number | 1952928913
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Entity Type | Individual
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Provider Name | LIZMAR RODRIGUEZ DC
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Gender | Female
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1200 FLORAL SPRINGS BLVD UNIT 27308
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City | PORT ORANGE
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State | FL
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Zip | 32129-6844
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Country | US
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Telephone | 787-457-8522
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1058
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City | CAMUY
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State | PR
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Zip | 00627-1058
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Country | US
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Telephone |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13309
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License Number State | FL
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