Provider Demographics
NPI:1659363166
Name:RODRIGUEZ, LUANA (DNP, CNM, CCTP)
Entity Type:Individual
Prefix:DR
First Name:LUANA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DNP, CNM, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20655 W LEGEND TRL
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-1756
Mailing Address - Country:US
Mailing Address - Phone:954-682-7069
Mailing Address - Fax:
Practice Address - Street 1:20655 W LEGEND TRL
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-1756
Practice Address - Country:US
Practice Address - Phone:954-682-7069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN151992163W00000X
FLARNP9178401367A00000X
AZAP3016367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306388700Medicaid
FLU4112ZMedicare PIN
FL306388700Medicaid