Provider Demographics
NPI:1083835144
Name:RODRIGUEZ, JESUS RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:RAMON
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7150 W 20TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5532
Mailing Address - Country:US
Mailing Address - Phone:305-557-3833
Mailing Address - Fax:305-557-3349
Practice Address - Street 1:7150 W 20TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5532
Practice Address - Country:US
Practice Address - Phone:305-557-3833
Practice Address - Fax:305-557-3349
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL164132086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery