Provider Demographics
NPI:1932127503
Name:RODRIGUEZ, JULIO ALEJANDRO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:ALEJANDRO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 SW 99TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4667
Mailing Address - Country:US
Mailing Address - Phone:305-274-9656
Mailing Address - Fax:305-274-0556
Practice Address - Street 1:7100 SW 99TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4667
Practice Address - Country:US
Practice Address - Phone:305-274-9656
Practice Address - Fax:305-274-0556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN147781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice