Provider Demographics
NPI:1740245141
Name:RODRIGUEZ, RIGOBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RIGOBERTO
Middle Name:
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 1:8353 SW 124 STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5847
Mailing Address - Country:US
Mailing Address - Phone:305-670-0332
Mailing Address - Fax:305-670-9436
Practice Address - Street 1:8353 SW 124 STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5847
Practice Address - Country:US
Practice Address - Phone:305-670-0332
Practice Address - Fax:305-670-9436
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME473912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD11954Medicare UPIN