Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9341478 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ARNP9341478 | FL |
NPI | 1013453018 |
---|---|
Provider Name | Karen Lorena Rodriguez |
First Address | Fort Myers, FL 33966-4805 |
Second Address | Fort Myers, FL 33966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2017 |
Last Update Date | 05/06/2019 |