Provider Demographics
NPI:1770820557
Name:RODRIGUEZ, LUIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BRADLEY PL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-3819
Mailing Address - Country:US
Mailing Address - Phone:561-832-1978
Mailing Address - Fax:
Practice Address - Street 1:135 BRADLEY PL
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3819
Practice Address - Country:US
Practice Address - Phone:561-832-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist