Provider Demographics
NPI:1275672834
Name:RODRIGUEZ, LEONARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:
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 1:4726 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1452
Mailing Address - Country:US
Mailing Address - Phone:305-446-9155
Mailing Address - Fax:305-446-1855
Practice Address - Street 1:4726 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1452
Practice Address - Country:US
Practice Address - Phone:305-446-9155
Practice Address - Fax:305-446-1855
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14820146D00000X
FLACN453208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant