MEDICARE: DR. CHRISTIAN 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	1223G0001X	General Practice Dentistry	DN31806	FL

General Provider Information

NPI Number	:	1699691832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN RODRIGUEZ

Provider Business Mailing Address
First Line	:	21200 SAINT ANDREWS BLVD STE 15
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-2403
Country	:	US
Telephone Number	:	561-571-7108
Fax Number	:	561-584-8162

Provider Business Practice Location Address
First Line	:	21200 SAINT ANDREWS BLVD STE 15
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-2403
Country	:	US
Telephone Number	:	561-571-7108
Fax Number	:	561-584-8162

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

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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