MEDICARE: DR. JUAN CARLOS RODRIGUEZ M.D.

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	ME87038	FL
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME87038	FL
3	207RP1001X	Pulmonary Disease Physician	ME87038	FL
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME87038	FL

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	:	1386646966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CARLOS RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	3484 MEADOWBROOK WAY
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-7327
Country	:	US
Telephone Number	:	954-271-0411
Fax Number	:	954-901-2727

Provider Business Practice Location Address
First Line	:	1601 N PALM AVE
Second Line	:	SUITE 109
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-3240
Country	:	US
Telephone Number	:	954-271-0411
Fax Number	:	954-206-0111

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	12/15/2016

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Directions to “ DR. JUAN CARLOS RODRIGUEZ M.D.” Practice Location

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