MEDICARE: DR. RAMON RODRIGUEZ III M.D., J.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	207Q00000X	Family Medicine Physician	0101223904	VA
2	207Q00000X	Family Medicine Physician	C-8408	AR
3	207Q00000X	Family Medicine Physician	ME66807	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689635195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON RODRIGUEZ III M.D., J.D.

Provider Business Mailing Address
First Line	:	1111 E MAIN ST
Second Line	:	SUITE 1701
City	:	RICHMOND
State	:	VA
Zip	:	23219-3531
Country	:	US
Telephone Number	:	804-782-0608
Fax Number	:	804-782-0133

Provider Business Practice Location Address
First Line	:	1111 E MAIN ST
Second Line	:	SUITE 1701
City	:	RICHMOND
State	:	VA
Zip	:	23219-3531
Country	:	US
Telephone Number	:	804-782-0608
Fax Number	:	804-782-0133

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

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	04/28/2008

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