MEDICARE: ILEANA RODRIGUEZ

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	183500000X	Pharmacist	PS41898	FL

General Provider Information

NPI Number	:	1235521576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILEANA RODRIGUEZ

Provider Business Mailing Address
First Line	:	2525 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2408
Country	:	US
Telephone Number	:	813-870-1476
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2408
Country	:	US
Telephone Number	:	813-870-1476
Fax Number	:	813-871-2031

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

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	02/24/2015

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Directions to “ ILEANA RODRIGUEZ ” Practice Location

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