Provider Demographics
NPI:1275739724
Name:RODRIGUEZ, RONALD ARMANDO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ARMANDO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2630 E. 7TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-4319
Mailing Address - Country:US
Mailing Address - Phone:704-364-6110
Mailing Address - Fax:704-364-4245
Practice Address - Street 1:2630 E. 7TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4319
Practice Address - Country:US
Practice Address - Phone:704-364-6110
Practice Address - Fax:704-364-4245
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2023-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002419363A00000X
NC0010-02449363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant