Provider Demographics
NPI:1679748917
Name:RODRIGUEZ-GOMEZ, ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RODRIGUEZ-GOMEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4222
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:15800 SW 25TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4222
Practice Address - Country:US
Practice Address - Phone:954-364-9000
Practice Address - Fax:954-538-0229
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist