Provider Demographics
NPI:1598166266
Name:RODRIGUEZ, ALEX DAVID (PA)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:DAVID
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7176
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:9598 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5429
Practice Address - Country:US
Practice Address - Phone:813-341-3454
Practice Address - Fax:813-341-3464
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2019-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9108220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant