Provider Demographics
NPI:1407159023
Name:RODRIGUEZ, REYNA YOLANDA (PA)
Entity Type:Individual
Prefix:MRS
First Name:REYNA
Middle Name:YOLANDA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 278004
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-8004
Mailing Address - Country:US
Mailing Address - Phone:305-231-8996
Mailing Address - Fax:
Practice Address - Street 1:777 E 25TH ST STE 304
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3849
Practice Address - Country:US
Practice Address - Phone:305-231-8996
Practice Address - Fax:305-231-8433
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9100749363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant