MEDICARE: JOSE W RODRIGUEZ MD PA

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1699708354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE W RODRIGUEZ MD PA

Provider Business Mailing Address
First Line	:	PO BOX 21246
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-1246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 W SAINT ISABEL ST
Second Line	:	STE E
City	:	TAMPA
State	:	FL
Zip	:	33607-6371
Country	:	US
Telephone Number	:	813-878-2229
Fax Number	:

Authorized Official
Title or Position	:	OWNER / PROVIDER
Name	:	JOSE RODRIGUEZ
Credential	:
Telephone Number	:	813-878-2229

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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