Provider Demographics
NPI:1477265460
Name:RODRIGUEZ TELEHEALTH LLC
Entity Type:Organization
Organization Name:RODRIGUEZ TELEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-915-4211
Mailing Address - Street 1:14601 DURBIN ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7067
Mailing Address - Country:US
Mailing Address - Phone:305-490-5128
Mailing Address - Fax:
Practice Address - Street 1:14601 DURBIN ISLAND WAY
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-7067
Practice Address - Country:US
Practice Address - Phone:305-490-5128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care