Provider Demographics
NPI:1043726474
Name:RODRIGUEZ-VILA, JESENIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JESENIA
Middle Name:
Last Name:RODRIGUEZ-VILA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JESENIA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:6433 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3907
Mailing Address - Country:US
Mailing Address - Phone:786-370-0254
Mailing Address - Fax:
Practice Address - Street 1:6433 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:786-370-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9356790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily