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NPI Code Detail

MEDICARE: JOSE RODRIGUEZ

MEDICARE: JOSE 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1811750292
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE RODRIGUEZ
Provider Business Mailing Address
First Line : 1771 E FLAMINGO RD STE 114B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0839
Country : US
Telephone Number : 702-463-7779
Fax Number :
Provider Business Practice Location Address
First Line : 1771 E FLAMINGO RD STE 114B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0839
Country : US
Telephone Number : 702-463-7779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 01/30/2024

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Directions to “ JOSE RODRIGUEZ ” Practice Location

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