Provider Demographics
NPI:1326113879
Name:RODRIGUEZ, PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
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 1:3309 SW 34TH CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-3392
Mailing Address - Country:US
Mailing Address - Phone:352-237-0509
Mailing Address - Fax:352-237-9808
Practice Address - Street 1:1500 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6504
Practice Address - Country:US
Practice Address - Phone:352-237-0509
Practice Address - Fax:352-237-9808
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72082207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592689712OtherUHC PRVDR
FL251998400Medicaid
FLN146227OtherWC HLTHEZ
FL41266OtherBCBS PRVDR
FL41266OtherBCBS PRVDR
FLN146227OtherWC HLTHEZ