Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | ME 57498 | FL |
NPI | 1639191869 |
---|---|
Provider Name | Roberto Rodriguez |
First Address | Miami, FL 33144-2035 |
Second Address | Miami, FL 33144-2035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 29/11/2007 |