Provider Demographics
NPI:1770218968
Name:RODRIGUEZ, ESTHER RUTH (CRDH)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:RUTH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17990 NE 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1602
Mailing Address - Country:US
Mailing Address - Phone:786-478-8362
Mailing Address - Fax:
Practice Address - Street 1:12331 SW 3RD ST # 450
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325-2813
Practice Address - Country:US
Practice Address - Phone:786-478-8362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH27168124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist