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NPI Code Detail

MEDICARE: DR. ALEXANDER RODRIGUEZ M.D.

MEDICARE: DR. ALEXANDER RODRIGUEZ M.D.
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
1208D00000XGeneral Practice Physician16424PR
2208D00000XGeneral Practice PhysicianACN534FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ACN534OTHERFLMEDICAL LICENSE FLORIDA
216424OTHERPRPR MEDICAL LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548480825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDER RODRIGUEZ M.D.
Provider Business Mailing Address
First Line : PO BOX 878
Second Line :
City : DAVENPORT
State : FL
Zip : 33836-0878
Country : US
Telephone Number : 689-223-3898
Fax Number : 689-223-3898
Provider Business Practice Location Address
First Line : 106 PARK PLACE BLVD STE C
Second Line :
City : DAVENPORT
State : FL
Zip : 33837-6868
Country : US
Telephone Number : 863-588-4775
Fax Number : 863-422-7664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2007
Last Update Date : 08/27/2024

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