MEDICARE: CESAR OSCAR RODRIGUEZ SUSANA DDS

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	1223G0001X	General Practice Dentistry	DN29405	FL
2	122300000X	Dentist	0401418693	VA

General Provider Information

NPI Number	:	1538800420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR OSCAR RODRIGUEZ SUSANA DDS

Provider Business Mailing Address
First Line	:	505 WEKIVA SPRINGS RD STE 100
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6050
Country	:	US
Telephone Number	:	321-594-2628
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 WEKIVA SPRINGS RD STE 100
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6050
Country	:	US
Telephone Number	:	321-594-2628
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	07/16/2024

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Directions to “ CESAR OSCAR RODRIGUEZ SUSANA DDS” Practice Location

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