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NPI Code Detail

MEDICARE: DR. WILBERT DESS RODRIGUEZ M.D.

MEDICARE: DR. WILBERT DESS 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
1208D00000XGeneral Practice Physician17652PR
2208D00000XGeneral Practice PhysicianACN773FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117652OTHERPRCOLEGIO DE MEDICOS CIRUJANOS
2DM-17524-0OTHERPRASSMCA
317652OTHERPRMEDICAL LICENSE
479858OTHERPRREGISTRO JUNTA DE LICENCIAMIENTO Y DISCIPLINA MEDICA DE PR
5ACN773OTHERFLMEDICAL LICENSE
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952532046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILBERT DESS RODRIGUEZ M.D.
Provider Business Mailing Address
First Line : 121 S ORANGE AVE STE 940
Second Line :
City : ORLANDO
State : FL
Zip : 32801-3234
Country : US
Telephone Number : 407-658-9687
Fax Number : 407-658-9688
Provider Business Practice Location Address
First Line : 810 N NOWELL ST
Second Line :
City : ORLANDO
State : FL
Zip : 32808-7539
Country : US
Telephone Number : 407-290-9556
Fax Number : 407-290-9509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2009
Last Update Date : 03/07/2023

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