MEDICARE: MRS. CYNTHIA LYNNE RODRIGUEZ FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	602165	TX

General Provider Information

NPI Number	:	1043378276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA LYNNE RODRIGUEZ FNP

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	254-539-9582
Fax Number	:

Provider Business Practice Location Address
First Line	:	5026 CAMP BULLIS RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257
Country	:	US
Telephone Number	:	210-295-8070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/29/2022

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