MEDICARE: IVONNE 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
1	183700000X	Pharmacy Technician	310101050350369	FL

General Provider Information

NPI Number	:	1942377197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVONNE RODRIGUEZ

Provider Business Mailing Address
First Line	:	1268 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3921
Country	:	US
Telephone Number	:	305-885-8888
Fax Number	:	305-885-8890

Provider Business Practice Location Address
First Line	:	1268 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010
Country	:	US
Telephone Number	:	305-885-8888
Fax Number	:	305-885-8890

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/06/2024

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