Provider Demographics
NPI:1144211574
Name:RODRIGUEZ-JORGE, ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:RODRIGUEZ-JORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3185 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4533
Mailing Address - Country:US
Mailing Address - Phone:305-859-7719
Mailing Address - Fax:305-859-7839
Practice Address - Street 1:3185 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4533
Practice Address - Country:US
Practice Address - Phone:305-859-7719
Practice Address - Fax:305-859-7839
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM78063207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258184100Medicaid
FL258184100Medicaid
FLE3105BMedicare ID - Type Unspecified