Provider Demographics
NPI:1629660428
Name:RODRIGUEZ, DAYANA
Entity Type:Individual
Prefix:
First Name:DAYANA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2057
Mailing Address - Country:US
Mailing Address - Phone:305-290-4001
Mailing Address - Fax:786-534-4966
Practice Address - Street 1:4131 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2057
Practice Address - Country:US
Practice Address - Phone:305-290-4001
Practice Address - Fax:786-534-4966
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010703363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner