Provider Demographics
NPI:1649592098
Name:RODRIGUEZ, AMY TANNER (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:TANNER
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3-3420 KUHIO HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1098
Mailing Address - Country:US
Mailing Address - Phone:808-245-1500
Mailing Address - Fax:808-246-1365
Practice Address - Street 1:3-3420 KUHIO HWY
Practice Address - Street 2:SUITE B
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1098
Practice Address - Country:US
Practice Address - Phone:808-245-1500
Practice Address - Fax:808-246-1365
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2012-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD16080208600000X
CAA104141208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery