MEDICARE: JOANNA M 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	207RN0300X	Nephrology Physician	ME87467	FL

General Provider Information

NPI Number	:	1801973896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOANNA M RODRIGUEZ MD PA

Provider Business Mailing Address
First Line	:	11011 SHERIDAN ST
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33026-1505
Country	:	US
Telephone Number	:	954-435-4401
Fax Number	:	954-435-4481

Provider Business Practice Location Address
First Line	:	11011 SHERIDAN ST
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33026-1505
Country	:	US
Telephone Number	:	954-435-4401
Fax Number	:	954-435-4481

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOANNA M RODRIGUEZ
Credential	:	M.D.
Telephone Number	:	954-435-4401

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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