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NPI Code Detail

MEDICARE: IHAN RODRIGUEZ D.C.

MEDICARE: IHAN RODRIGUEZ D.C.
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
1111N00000XChiropractorCH7493FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
155639OTHERFLBCBS
2648670OTHERFLACN UNITED HEALTHCARE

General Provider Information

NPI Number : 1356566368
Entity Type Code : Individual
Provider Name (Legal Business Name) : IHAN RODRIGUEZ D.C.
Provider Business Mailing Address
First Line : PO BOX 2820
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-2820
Country : US
Telephone Number : 407-933-1500
Fax Number :
Provider Business Practice Location Address
First Line : 711 E OAK ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-4573
Country : US
Telephone Number : 407-933-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/08/2007

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Directions to “ IHAN RODRIGUEZ D.C.” Practice Location

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