Provider Demographics
NPI:1093147738
Name:RODRIGUEZ, YAQUELIN (PA)
Entity Type:Individual
Prefix:
First Name:YAQUELIN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5045
Mailing Address - Country:US
Mailing Address - Phone:305-663-1016
Mailing Address - Fax:
Practice Address - Street 1:300 71ST ST STE 530
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3087
Practice Address - Country:US
Practice Address - Phone:786-554-2254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center