Provider Demographics
NPI:1154479434
Name:RODRIGUEZ, DARIO ALFONSO (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARIO
Middle Name:ALFONSO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 BOND LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9612
Mailing Address - Country:US
Mailing Address - Phone:407-920-1361
Mailing Address - Fax:407-696-9283
Practice Address - Street 1:1013 LOCKWOOD BLVD
Practice Address - Street 2:#7
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6001
Practice Address - Country:US
Practice Address - Phone:407-278-0934
Practice Address - Fax:407-278-0939
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN127801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice