MEDICARE: DR VICTORIO C RODRIGUEZ MD PMA CO

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	261Q00000X	Clinic/Center	034349	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083673206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR VICTORIO C RODRIGUEZ MD PMA CO

Provider Business Mailing Address
First Line	:	3345 E 55TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1547
Country	:	US
Telephone Number	:	216-441-4432
Fax Number	:

Provider Business Practice Location Address
First Line	:	3345 E 55TH ST
Second Line	:	7791 HOERTZ RD., PARMA,OHIO,44134(BUSINESS MAILING)
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1547
Country	:	US
Telephone Number	:	216-441-4432
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICTORIO CAJIGAL RODRIGUEZ
Credential	:	M.D.
Telephone Number	:	216-441-4432

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	06/17/2008

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