Provider Demographics
NPI:1487861498
Name:RODRIGO, RODNEY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DAVID
Last Name:RODRIGO
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 1:10730 KETCHUM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7185
Mailing Address - Country:US
Mailing Address - Phone:813-331-4465
Mailing Address - Fax:813-280-4855
Practice Address - Street 1:5100 W KENNEDY BLVD STE 280
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1892
Practice Address - Country:US
Practice Address - Phone:813-331-4465
Practice Address - Fax:813-280-4855
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104971208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME104971OtherFLORIDA LICENSE
FLME104971OtherFLORIDA LICENSE