Provider Demographics
NPI:1578618294
Name:RODRIGUEZ DEL-RIO, FELIX ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:ALBERTO
Last Name:RODRIGUEZ DEL-RIO
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 1:900 CIRCLE 75 PKWY SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:3929 PEACHTREE RD NE STE 250
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3374
Practice Address - Country:US
Practice Address - Phone:404-352-1053
Practice Address - Fax:404-350-0840
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11568207XX0004X, 207X00000X, 207XX0005X
AL00021612207XX0004X, 207XX0005X
GA81872207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0090028Medicare ID - Type Unspecified
PRG81756Medicare UPIN