Provider Demographics
NPI:1821164534
Name:RODRIGUEZ, ANGELA CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CRISTINA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 N COMMERCE PARKWAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-659-8550
Mailing Address - Fax:954-659-8770
Practice Address - Street 1:1625 N COMMERCE PARKWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-659-8550
Practice Address - Fax:954-659-8770
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82147208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262872400Medicaid