Provider Demographics
NPI:1700041084
Name:RODRIGUEZ, CESAR A (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19620 E OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2051
Mailing Address - Country:US
Mailing Address - Phone:305-454-0721
Mailing Address - Fax:305-454-0721
Practice Address - Street 1:19620 E OAKMONT DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2051
Practice Address - Country:US
Practice Address - Phone:305-454-0721
Practice Address - Fax:305-454-0721
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME 103297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program