Provider Demographics
NPI:1578531794
Name:RODRIGUEZ, LEOPOLDO VICENTE (MD)
Entity Type:Individual
Prefix:DR
First Name:LEOPOLDO
Middle Name:VICENTE
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LEOPOLDO
Other - Middle Name:G
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 21147
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4147
Mailing Address - Country:US
Mailing Address - Phone:303-415-2532
Mailing Address - Fax:303-785-1725
Practice Address - Street 1:4450 ARAPAHOE AVE STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-9102
Practice Address - Country:US
Practice Address - Phone:303-415-2532
Practice Address - Fax:303-785-1725
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79960207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H26570Medicare UPIN
FL35258YMedicare ID - Type Unspecified
FL35258XMedicare ID - Type Unspecified