MEDICARE: SAUL A. RODRIGUEZ M.D.

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	207R00000X	Internal Medicine Physician	ME15570	FL

General Provider Information

NPI Number	:	1841695442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAUL A. RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9733
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32417-0133
Country	:	US
Telephone Number	:	786-942-0579
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 FOREST PARK CIRCLE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4919
Country	:	US
Telephone Number	:	786-942-0579
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAUL AHMED RODRIGUEZ
Credential	:	M.D.
Telephone Number	:	786-942-0579

Provider Enumeration Date	:	10/27/2014
Last Update Date	:	10/27/2014

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