Provider Demographics
NPI:1083179998
Name:BALDRIZ RODRIGUEZ, ADRIANA MARIA (SA-C)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MARIA
Last Name:BALDRIZ RODRIGUEZ
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 SW 164TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5289
Mailing Address - Country:US
Mailing Address - Phone:786-718-7581
Mailing Address - Fax:
Practice Address - Street 1:4217 SW 164TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5289
Practice Address - Country:US
Practice Address - Phone:786-718-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-118246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant