MEDICARE: MARIA RODRIGUEZ FNP

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	363LF0000X	Family Nurse Practitioner	95036224	CA

General Provider Information

NPI Number	:	1649154980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA RODRIGUEZ FNP

Provider Business Mailing Address
First Line	:	1723 CEDAR AVE UNIT 102
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1793
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1723 CEDAR AVE UNIT 102
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1793
Country	:	US
Telephone Number	:	714-381-0214
Fax Number	:

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

Provider Enumeration Date	:	07/31/2025
Last Update Date	:	07/31/2025

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