Provider Demographics
NPI:1578199923
Name:RODRIGUEZ MOLINA, ROBERTO J
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:J
Last Name:RODRIGUEZ MOLINA
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 1:7505 NEW HAMPSHIRE AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6972
Mailing Address - Country:US
Mailing Address - Phone:301-576-0500
Mailing Address - Fax:
Practice Address - Street 1:7505 NEW HAMPSHIRE AVE STE 320
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6972
Practice Address - Country:US
Practice Address - Phone:301-576-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS04050111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation