MEDICARE: CHRISTIAN ULIS RODRIGUEZ

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	237700000X	Hearing Instrument Specialist	AS5738	FL

General Provider Information

NPI Number	:	1699457036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN ULIS RODRIGUEZ

Provider Business Mailing Address
First Line	:	1515 SWEET APPLE ST
Second Line	:
City	:	OAKLAND
State	:	FL
Zip	:	34787-3771
Country	:	US
Telephone Number	:	407-394-5066
Fax Number	:

Provider Business Practice Location Address
First Line	:	13900 COUNTY ROAD 455 UNIT 112
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-9020
Country	:	US
Telephone Number	:	407-554-3390
Fax Number	:

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

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	10/11/2023

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Directions to “ CHRISTIAN ULIS RODRIGUEZ ” Practice Location

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