Provider Demographics
NPI:1942386305
Name:RODRIGUEZ, ALEJANDRO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
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 1:2921 SW 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2313
Mailing Address - Country:US
Mailing Address - Phone:305-297-7597
Mailing Address - Fax:
Practice Address - Street 1:1470 NW 107TH AVE
Practice Address - Street 2:SUITE F
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2744
Practice Address - Country:US
Practice Address - Phone:305-594-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist