MEDICARE: AILEEN RODRIGUEZ APRN

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	APRN9376436	FL

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	:	1174091102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN RODRIGUEZ APRN

Provider Business Mailing Address
First Line	:	6560 LAKE COMO TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-3033
Country	:	US
Telephone Number	:	786-973-0068
Fax Number	:

Provider Business Practice Location Address
First Line	:	6560 LAKE COMO TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-3033
Country	:	US
Telephone Number	:	786-973-0068
Fax Number	:

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

Provider Enumeration Date	:	11/07/2018
Last Update Date	:	11/07/2018

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Directions to “ AILEEN RODRIGUEZ APRN” Practice Location

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