Provider Demographics
NPI:1225068810
Name:RODRIGUEZ, FELIPE A (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 LIVINGSTON RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5104
Mailing Address - Country:US
Mailing Address - Phone:301-292-7171
Mailing Address - Fax:301-292-2890
Practice Address - Street 1:11701 LIVINGSTON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5104
Practice Address - Country:US
Practice Address - Phone:301-292-7171
Practice Address - Fax:301-292-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035174208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD#E33253Medicare UPIN