Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9353293 | FL |
NPI | 1033635032 |
---|---|
Provider Name | Marcos Antonio Rodriguez Morales |
First Address | Homestead, FL 33032-3418 |
Second Address | North Miami Beach, FL 33162-3511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 21/08/2017 |