Provider Demographics
NPI:1609388784
Name:RODRIGUEZ, DIEGO F (CRNA)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:F
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13334 SW 111TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4349
Mailing Address - Country:US
Mailing Address - Phone:305-878-5148
Mailing Address - Fax:
Practice Address - Street 1:13334 SW 111TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4349
Practice Address - Country:US
Practice Address - Phone:305-878-5148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9320955163W00000X
FLARNP9320955367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse