Provider Demographics
NPI:1346730181
Name:RODRIGUEZ, JUANA MARIA (BS,IBCLC)
Entity Type:Individual
Prefix:
First Name:JUANA
Middle Name:MARIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BS,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4539 SW 15TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6314
Mailing Address - Country:US
Mailing Address - Phone:239-851-0909
Mailing Address - Fax:866-229-4468
Practice Address - Street 1:4539 SW 15TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6314
Practice Address - Country:US
Practice Address - Phone:239-851-0909
Practice Address - Fax:866-229-4468
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN