MEDICARE: SAUL AHMED 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	ME115570	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851672620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAUL AHMED RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 9733
Second Line	:
City	:	PANAMA CITY BCH
State	:	FL
Zip	:	32417
Country	:	US
Telephone Number	:	786-972-0579
Fax Number	:	850-248-2469

Provider Business Practice Location Address
First Line	:	280 FOREST PARK CIR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4919
Country	:	US
Telephone Number	:	850-215-3932
Fax Number	:	850-215-3959

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

Provider Enumeration Date	:	09/07/2011
Last Update Date	:	06/15/2017

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