Provider Demographics
NPI:1497946560
Name:RODRIQUEZ, RONALD FRANCISO
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:FRANCISO
Last Name:RODRIQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E BURLEIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-2401
Mailing Address - Country:US
Mailing Address - Phone:352-253-9100
Mailing Address - Fax:352-253-0126
Practice Address - Street 1:115 E BURLEIGH BLVD
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-2401
Practice Address - Country:US
Practice Address - Phone:352-253-9100
Practice Address - Fax:352-253-0126
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23005208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation