MEDICARE: ANA LAURA 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	208000000X	Pediatrics Physician	036157401	IL
2	208000000X	Pediatrics Physician	ME166582	FL

General Provider Information

NPI Number	:	1255836136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA LAURA RODRIGUEZ

Provider Business Mailing Address
First Line	:	3622 CORAL WAY APT 1301
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3293
Country	:	US
Telephone Number	:	786-325-6018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1567 SAN REMO AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-3008
Country	:	US
Telephone Number	:	786-424-2006
Fax Number	:

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

Provider Enumeration Date	:	03/24/2018
Last Update Date	:	08/05/2024

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Directions to “ ANA LAURA RODRIGUEZ ” Practice Location

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