Provider Demographics
NPI:1508839408
Name:RODRIGUEZ, ANTONIO M (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3200 SW 60TH CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4000
Mailing Address - Country:US
Mailing Address - Phone:305-662-8380
Mailing Address - Fax:305-663-8417
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4000
Practice Address - Country:US
Practice Address - Phone:305-662-8380
Practice Address - Fax:305-663-8417
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2016-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME00389552080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251315300Medicaid
FL251315300Medicaid