Provider Demographics
NPI:1093489056
Name:DANIEL RODRIGUEZ APRN, LLC.
Entity Type:Organization
Organization Name:DANIEL RODRIGUEZ APRN, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING
Authorized Official - Phone:305-606-0337
Mailing Address - Street 1:16468 NW 86TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6145
Mailing Address - Country:US
Mailing Address - Phone:305-972-4534
Mailing Address - Fax:305-466-9543
Practice Address - Street 1:16468 NW 86TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-6145
Practice Address - Country:US
Practice Address - Phone:305-972-4534
Practice Address - Fax:305-466-9543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center