Provider Demographics
NPI:1811596083
Name:LOUIS ANTONIO RODRIGUEZ
Entity Type:Organization
Organization Name:LOUIS ANTONIO RODRIGUEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-527-4436
Mailing Address - Street 1:6303 BLUE LAGOON DR STE 335
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6002
Mailing Address - Country:US
Mailing Address - Phone:786-527-4436
Mailing Address - Fax:
Practice Address - Street 1:6303 BLUE LAGOON DR STE 335
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6002
Practice Address - Country:US
Practice Address - Phone:786-527-4436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)