Provider Demographics
NPI:1679898589
Name:RODRIGUEZ, ANGEL A (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17211 NW 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-4010
Mailing Address - Country:US
Mailing Address - Phone:305-642-4777
Mailing Address - Fax:305-642-0600
Practice Address - Street 1:8260 W FLAGLER ST STE 1G
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:786-444-4084
Practice Address - Fax:786-452-9536
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3426213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO 3426OtherFLORIDA LICENCE