Provider Demographics
NPI:1780657379
Name:RODRIGUEZ, ANTONIO ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:ENRIQUE
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 896206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6206
Mailing Address - Country:US
Mailing Address - Phone:910-938-3099
Mailing Address - Fax:910-938-3243
Practice Address - Street 1:4275 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-1100
Practice Address - Country:US
Practice Address - Phone:910-938-3099
Practice Address - Fax:910-938-3243
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-03-17
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Provider Licenses
StateLicense IDTaxonomies
NC201302472207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease