MEDICARE: CYNTHIA STEPHENSON RODRIGUEZ O.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	152W00000X	Optometrist	2557	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	:	1609059161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA STEPHENSON RODRIGUEZ O.D.

Provider Business Mailing Address
First Line	:	141 WISTERIA DR
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4951
Country	:	US
Telephone Number	:	407-682-2018
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 E ALTAMONTE DR
Second Line	:	SUITE #1467
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4613
Country	:	US
Telephone Number	:	407-830-6546
Fax Number	:	407-830-9132

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

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/06/2007

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