Doctor Name: | LUCY A RODRIGUEZ |
NPI Number: | 1225368111 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 17805 |
Business Practice Address: | 1111 S Semoran Blvd Suite B Orlando, FL - 328071480 |
Business Phone Number: | 4079301112 |
Business Fax Number: | |
Mailing Address: | 14120 Sanctuary Club Rd, Unit 109 ORLANDO |
State: | FL |
Postal Code: | 328326645 |
Phone Number: | 4079301112 |
Fax Number: | 4079301114 |
NPI Enumeration Date: | 12/28/2009 |
NPI Last Update Date: | 02/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17805 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |