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NPI Code Detail

MEDICARE: VINCENT NMI RODRIGUEZ PHD

MEDICARE: VINCENT NMI RODRIGUEZ PHD
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
1171M00000XCase Manager/Care Coordinator
2101YP2500XProfessional CounselorCI0324NV

General Provider Information

NPI Number : 1346473154
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT NMI RODRIGUEZ PHD
Provider Business Mailing Address
First Line : 10280 GAETA PL
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-2603
Country : US
Telephone Number : 702-762-0588
Fax Number :
Provider Business Practice Location Address
First Line : 2740 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5398
Country : US
Telephone Number : 702-248-8866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2009
Last Update Date : 09/27/2021

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