Provider Demographics
NPI:1326382599
Name:RODRIGUEZ, RANCEL (ARNP)
Entity Type:Individual
Prefix:
First Name:RANCEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18004 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5209
Mailing Address - Country:US
Mailing Address - Phone:305-495-9867
Mailing Address - Fax:954-885-6381
Practice Address - Street 1:18004 SW 20TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5209
Practice Address - Country:US
Practice Address - Phone:305-495-9867
Practice Address - Fax:954-885-6381
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9245140363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner