Provider Demographics
NPI:1659094738
Name:RODRIGUEZ GARCIA, LEYDIANIS (DDS)
Entity Type:Individual
Prefix:
First Name:LEYDIANIS
Middle Name:
Last Name:RODRIGUEZ GARCIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9014 W FLAGLER ST APT 11
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3906
Mailing Address - Country:US
Mailing Address - Phone:786-253-6292
Mailing Address - Fax:
Practice Address - Street 1:9014 W FLAGLER ST APT 11
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3906
Practice Address - Country:US
Practice Address - Phone:786-253-6292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0045481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice