MEDICARE: MARTHA M RODRIGUEZ MD PA

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	ME63688	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	:	1396841235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTHA M RODRIGUEZ MD PA

Provider Business Mailing Address
First Line	:	2015 OCEAN DR
Second Line	:	STE 11
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5131
Country	:	US
Telephone Number	:	561-364-8056
Fax Number	:	561-364-8507

Provider Business Practice Location Address
First Line	:	2015 OCEAN DR
Second Line	:	STE 11
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5131
Country	:	US
Telephone Number	:	561-364-8056
Fax Number	:	561-364-8507

Authorized Official
Title or Position	:	OWNER
Name	:	MARTHA MERCEDES RODRIGUEZ
Credential	:	M.D.
Telephone Number	:	561-364-8056

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	11/05/2008

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