Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME115868 | FL |
NPI | 1285868943 |
---|---|
Provider Name | Alejandro Rafael Rodriguez |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33606-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 11/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017768500 | (05) | FL |
IP436Z | (02) | FL |
Z6FDU | BLUE CROSS BLUE SHIELD (01) | FL |