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NPI Code Detail

MEDICARE: JUAN JERONIMO RODRIGUEZ

MEDICARE: JUAN JERONIMO 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
1175T00000XPeer Specialist0001927OH

General Provider Information

NPI Number : 1427662360
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN JERONIMO RODRIGUEZ
Provider Business Mailing Address
First Line : 4315 CLARK AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1120
Country : US
Telephone Number : 216-315-2270
Fax Number :
Provider Business Practice Location Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number : 440-340-5575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2020
Last Update Date : 09/08/2020

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Directions to “ JUAN JERONIMO RODRIGUEZ ” Practice Location

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