Provider Demographics
NPI:1881188365
Name:RODRIGUEZ BOLOIX, LISBET (ARNP)
Entity Type:Individual
Prefix:
First Name:LISBET
Middle Name:
Last Name:RODRIGUEZ BOLOIX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14869 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3335
Mailing Address - Country:US
Mailing Address - Phone:786-970-4026
Mailing Address - Fax:
Practice Address - Street 1:14869 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3335
Practice Address - Country:US
Practice Address - Phone:786-970-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9269001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty