Provider Demographics
NPI:1033177118
Name:RODRIGUEZ, MARIA ELENA G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA ELENA
Middle Name:G
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 W MICHIGAN AVE STE 10C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-2346
Mailing Address - Country:US
Mailing Address - Phone:850-332-6788
Mailing Address - Fax:888-660-1953
Practice Address - Street 1:945 W MICHIGAN AVE STE 10C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-2346
Practice Address - Country:US
Practice Address - Phone:850-332-6788
Practice Address - Fax:888-660-1953
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164691208000000X
FLME107976208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY265138OtherMVP
FL002638000Medicaid
NY00924272Medicaid
NY01121400OtherBCBS
NY265138OtherMVP