Provider Demographics
NPI:1629232335
Name:RODRIGUEZ-HOUDER, MARIA DELCARMEN (PA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DELCARMEN
Last Name:RODRIGUEZ-HOUDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 HAM BROWN RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3415
Mailing Address - Country:US
Mailing Address - Phone:407-452-1086
Mailing Address - Fax:407-452-1068
Practice Address - Street 1:2651 HAM BROWN RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3415
Practice Address - Country:US
Practice Address - Phone:407-452-1086
Practice Address - Fax:407-452-1068
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100750363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant