MEDICARE: JASMARI 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	247200000X	Other Technician

General Provider Information

NPI Number	:	1427588128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMARI RODRIGUEZ

Provider Business Mailing Address
First Line	:	4575 SE DIXIE HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-6826
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 W CYPRESS CREEK RD STE 120
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1947
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	06/14/2017

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Directions to “ JASMARI RODRIGUEZ ” Practice Location

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