Provider Demographics
NPI:1366495228
Name:RODRIGUEZ, CRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
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 1:3450 N BEAUREGARD ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1200
Mailing Address - Country:US
Mailing Address - Phone:703-824-9397
Mailing Address - Fax:703-820-5564
Practice Address - Street 1:3450 N BEAUREGARD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1200
Practice Address - Country:US
Practice Address - Phone:703-824-9397
Practice Address - Fax:703-820-5564
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010112391272080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology