Provider Demographics
NPI:1346422854
Name:RODRIGUEZ, VICTORIO CAJIGAL (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIO
Middle Name:CAJIGAL
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 1:3345 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1547
Mailing Address - Country:US
Mailing Address - Phone:216-441-4432
Mailing Address - Fax:
Practice Address - Street 1:3345 E 55TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1547
Practice Address - Country:US
Practice Address - Phone:216-441-4432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034349261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207912Medicaid
OH1083673206OtherTYPE 2 -- NPI-CORPORATION
OH1346422854OtherINDIVIDUAL NPI
OHA74277Medicare UPIN
OH0379412Medicare PIN