Provider Demographics
NPI:1033688916
Name:RODRIGUEZ, ROLAND (DC)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 NEWBERRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2386
Mailing Address - Country:US
Mailing Address - Phone:352-215-1942
Mailing Address - Fax:386-200-5812
Practice Address - Street 1:4020 NEWBERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2386
Practice Address - Country:US
Practice Address - Phone:352-215-1942
Practice Address - Fax:386-200-5812
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor