Provider Demographics
NPI:1629366380
Name:FLORENTIN RODRIGUEZ, DIEGO (MD)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:FLORENTIN RODRIGUEZ
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 1:5205 BABCOCK ST NE STE 3
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4638
Mailing Address - Country:US
Mailing Address - Phone:321-729-1400
Mailing Address - Fax:321-728-5700
Practice Address - Street 1:5205 BABCOCK ST NE STE 3
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4638
Practice Address - Country:US
Practice Address - Phone:321-729-1400
Practice Address - Fax:321-728-5700
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2013-0831207R00000X
MI4301098613207R00000X
FLME129433207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine