Provider Demographics
NPI:1790376242
Name:SILVA RODRIGUEZ, JOANNIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JOANNIE
Middle Name:
Last Name:SILVA RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 CITRUS TOWER BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6885
Mailing Address - Country:US
Mailing Address - Phone:352-243-0206
Mailing Address - Fax:352-243-1822
Practice Address - Street 1:3175 CITRUS TOWER BLVD STE B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6885
Practice Address - Country:US
Practice Address - Phone:352-243-0206
Practice Address - Fax:352-243-1822
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily