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NPI Code Detail

MEDICARE: WILFREDO RODRIGUEZ M.S.N., R.N.

MEDICARE: WILFREDO RODRIGUEZ M.S.N., R.N.
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538986278
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILFREDO RODRIGUEZ M.S.N., R.N.
Provider Business Mailing Address
First Line : 550 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-2154
Country : US
Telephone Number : 602-496-0607
Fax Number :
Provider Business Practice Location Address
First Line : 550 N 3RD STREET
Second Line : HEALTH BUILDING NORTH 3RD FLOOR
City : PHOENIX
State : AZ
Zip : 85004
Country : US
Telephone Number : 602-496-0607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 03/12/2026

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