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NPI Code Detail

MEDICARE: STEPHANIE RODRIGUEZ APRN

MEDICARE: STEPHANIE 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
1363LF0000XFamily Nurse PractitionerAPRN11015948FL
2163WR0006XRegistered Nurse First AssistantRN9373249FL

General Provider Information

NPI Number : 1184147456
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE RODRIGUEZ APRN
Provider Business Mailing Address
First Line : 71 E 58TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-1241
Country : US
Telephone Number : 305-333-4793
Fax Number :
Provider Business Practice Location Address
First Line : 3499 W 4TH AVE STE 201
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4333
Country : US
Telephone Number : 305-558-0411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 05/01/2023

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