Provider Demographics
NPI:1629228069
Name:RODRIGUEZ, FRANKIE (DC)
Entity Type:Individual
Prefix:
First Name:FRANKIE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1551
Mailing Address - Country:US
Mailing Address - Phone:407-931-3200
Mailing Address - Fax:
Practice Address - Street 1:2711 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1551
Practice Address - Country:US
Practice Address - Phone:407-931-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22655Medicare UPIN