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NPI Code Detail

MEDICARE: RAUL RODRIGUEZ R.EEG T

MEDICARE: RAUL RODRIGUEZ R.EEG T
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
1246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1649695958
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAUL RODRIGUEZ R.EEG T
Provider Business Mailing Address
First Line : 3008 DUMAS AVE
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-4567
Country : US
Telephone Number : 281-324-5660
Fax Number :
Provider Business Practice Location Address
First Line : 4830 W KENNEDY BLVD STE 600
Second Line :
City : TAMPA
State : FL
Zip : 33609-2584
Country : US
Telephone Number : 281-324-5660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2014
Last Update Date : 02/24/2014

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