Provider Demographics
NPI:1629853494
Name:RODRIGUEZ, RANDY J II
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:J
Last Name:RODRIGUEZ
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 CLAYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4146
Mailing Address - Country:US
Mailing Address - Phone:859-684-9907
Mailing Address - Fax:
Practice Address - Street 1:3436 CLAYS MILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-4146
Practice Address - Country:US
Practice Address - Phone:859-684-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY71835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric