MEDICARE: MARIA VARGAS 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1538748850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA VARGAS RODRIGUEZ

Provider Business Mailing Address
First Line	:	8100 SW 164TH ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-3723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 SW 164TH ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-3723
Country	:	US
Telephone Number	:	786-765-7917
Fax Number	:

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

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	04/05/2021

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Directions to “ MARIA VARGAS RODRIGUEZ ” Practice Location

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