Provider Demographics
NPI:1811582083
Name:RODRIGUEZ, MARIA G (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name: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 1:7655 W ATLANTIC BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7414
Mailing Address - Country:US
Mailing Address - Phone:954-663-3707
Mailing Address - Fax:
Practice Address - Street 1:2300 13TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2596
Practice Address - Country:US
Practice Address - Phone:706-243-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011943207Q00000X
GAGAA-NP000196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine