Provider Demographics
NPI:1659609410
Name:RODRIGUEZ, INES (APRN)
Entity Type:Individual
Prefix:MRS
First Name:INES
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 NW 12TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1821
Mailing Address - Country:US
Mailing Address - Phone:305-874-3909
Mailing Address - Fax:305-874-3916
Practice Address - Street 1:1176 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4700
Practice Address - Country:US
Practice Address - Phone:305-359-9838
Practice Address - Fax:786-224-6490
Is Sole Proprietor?:No
Enumeration Date:2009-12-05
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9243349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001924600Medicaid
FLDC740ZOtherMEDICARE