Provider Demographics
NPI:1891990685
Name:RODRIGUEZ, RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 MEDICAL BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1426
Mailing Address - Country:US
Mailing Address - Phone:239-596-8804
Mailing Address - Fax:239-596-8793
Practice Address - Street 1:1726 MEDICAL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1426
Practice Address - Country:US
Practice Address - Phone:239-596-8804
Practice Address - Fax:239-596-8793
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49037OtherBCBS
FL0001461 00Medicaid
FLP00667488OtherMEDICARE RAILROAD
FL0555020OtherCIGNA
FLP00667488OtherMEDICARE RAILROAD