Provider Demographics
NPI:1033635032
Name:RODRIGUEZ MORALES, MARCOS ANTONIO (ARNP)
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:ANTONIO
Last Name:RODRIGUEZ MORALES
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23746 SW 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3418
Mailing Address - Country:US
Mailing Address - Phone:305-799-5653
Mailing Address - Fax:
Practice Address - Street 1:16565 NE 4TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3511
Practice Address - Country:US
Practice Address - Phone:305-944-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9353293363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care