Provider Demographics
NPI:1083814941
Name:RODRIGUEZ, MARIA ISABEL
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 CONSERVATION DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2470
Mailing Address - Country:US
Mailing Address - Phone:954-659-7999
Mailing Address - Fax:
Practice Address - Street 1:5460 W STATE ROAD 84
Practice Address - Street 2:BAY #8
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-1241
Practice Address - Country:US
Practice Address - Phone:954-791-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10-91343900000X
FLVH1944343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)