Provider Demographics
NPI:1851017099
Name:RODRIGUEZ INFIESTA, BEXY (AGNP)
Entity Type:Individual
Prefix:
First Name:BEXY
Middle Name:
Last Name:RODRIGUEZ INFIESTA
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SW 138TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6888
Mailing Address - Country:US
Mailing Address - Phone:786-306-2678
Mailing Address - Fax:
Practice Address - Street 1:10200 SW 138TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6888
Practice Address - Country:US
Practice Address - Phone:786-306-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022482207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty