Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1144497371 |
---|---|
Provider Name | Luis F Rodriguez |
First Address | Davie, FL 33324-4415 |
Second Address | Davie, FL 33324-4415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 16/05/2008 |