Provider Demographics
NPI:1952688343
Name:RODAS, LUIS GERARDO JR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:GERARDO
Last Name:RODAS
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2013
Mailing Address - Country:US
Mailing Address - Phone:954-475-9222
Mailing Address - Fax:954-475-1240
Practice Address - Street 1:3015 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2013
Practice Address - Country:US
Practice Address - Phone:954-475-9222
Practice Address - Fax:954-475-1240
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist