Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME0038955 | FL |
NPI | 1508839408 |
---|---|
Provider Name | Antonio M. Rodriguez |
First Address | Miami, FL 33155-4000 |
Second Address | Miami, FL 33155-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 08/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251315300 | (05) | FL |
D59009 | (02) | FL |