Provider Demographics
NPI:1427384403
Name:RODRIGUEZ, CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WINDERLEY PL
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7267
Mailing Address - Country:US
Mailing Address - Phone:407-200-2700
Mailing Address - Fax:
Practice Address - Street 1:900 WINDERLEY PL
Practice Address - Street 2:SUITE 1400
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7267
Practice Address - Country:US
Practice Address - Phone:407-200-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10034479207R00000X
FLME114929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine