Provider Demographics
NPI:1881015071
Name:RODRIGUEZ, PEDRO ANGEL (ARNP)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:ANGEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 PORSCHE AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2801
Mailing Address - Country:US
Mailing Address - Phone:786-273-2871
Mailing Address - Fax:
Practice Address - Street 1:725 PORSCHE AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2801
Practice Address - Country:US
Practice Address - Phone:786-273-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-15
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9278796363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health