Provider Demographics
NPI:1679528871
Name:RODRIGUEZ, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 E ENID DR
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-2206
Mailing Address - Country:US
Mailing Address - Phone:305-361-8587
Mailing Address - Fax:305-361-8587
Practice Address - Street 1:251 E ENID DR
Practice Address - Street 2:
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149-2206
Practice Address - Country:US
Practice Address - Phone:305-361-8587
Practice Address - Fax:305-361-8587
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66804207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376495800Medicaid
FLF91328Medicare UPIN
FL376495800Medicaid