Provider Demographics
NPI:1922297878
Name:ARISTIZABAL, RODRIGO JAIME (DO 5343)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:JAIME
Last Name:ARISTIZABAL
Suffix:
Gender:M
Credentials:DO 5343
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 E 25TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3848
Mailing Address - Country:US
Mailing Address - Phone:305-691-9780
Mailing Address - Fax:305-691-5722
Practice Address - Street 1:555 E 25TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3848
Practice Address - Country:US
Practice Address - Phone:305-691-9780
Practice Address - Fax:305-691-5722
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDO5343156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician