Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH4496 | FL |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CH4496 | FL |
NPI | 1588706360 |
---|---|
Provider Name | Dr. Laz D Rodriguez |
First Address | Doral, FL 33178-7070 |
Second Address | Doral, FL 33178-7070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 09/08/2007 |