MEDICARE: ANGELICA N 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	390200000X	Student in an Organized Health Care Education/Training Program		FL

General Provider Information

NPI Number	:	1497419550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA N RODRIGUEZ

Provider Business Mailing Address
First Line	:	170 W 63RD ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2652
Country	:	US
Telephone Number	:	786-296-4958
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 S UNIVERSITY DR
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33328-2004
Country	:	US
Telephone Number	:	800-541-6682
Fax Number	:

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

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	02/28/2026

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