MEDICARE: CRISTINA B. 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
1	208000000X	Pediatrics Physician	ME66198	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588635726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA B. RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	4990 KEOHONE DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-2749
Country	:	US
Telephone Number	:	850-893-5709
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 E PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5301
Country	:	US
Telephone Number	:	850-877-7123
Fax Number	:	850-878-7036

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	07/08/2007

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