Provider Demographics
NPI:1043791148
Name:RODRIGUEZ-CHAPLE, SERGIO
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:
Last Name:RODRIGUEZ-CHAPLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 NW 77TH CT STE 308
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2072
Mailing Address - Country:US
Mailing Address - Phone:305-863-2233
Mailing Address - Fax:305-504-8813
Practice Address - Street 1:13925 SW 179TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-7743
Practice Address - Country:US
Practice Address - Phone:786-237-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9292612207Q00000X
FLARNP9292612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine