MEDICARE: DR. CARMELITA P RODRIGUEZ MD

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	207R00000X	Internal Medicine Physician	E2778	TX

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	:	1225046121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMELITA P RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	1730 SW MILITARY DR
Second Line	:	STE 201
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221
Country	:	US
Telephone Number	:	210-924-7356
Fax Number	:	210-924-0842

Provider Business Practice Location Address
First Line	:	1730 SW MILITARY DR
Second Line	:	STE 201
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221
Country	:	US
Telephone Number	:	210-924-7356
Fax Number	:	210-924-0842

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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