Provider Demographics
NPI:1659460855
Name:RODRIGUEZ, YANIRA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YANIRA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15325 73RD ST N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3190
Mailing Address - Country:US
Mailing Address - Phone:561-791-2763
Mailing Address - Fax:954-564-4768
Practice Address - Street 1:1150 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1245
Practice Address - Country:US
Practice Address - Phone:954-566-7474
Practice Address - Fax:954-564-4768
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS39119OtherSTATE LICENSE