Provider Demographics
NPI:1134829120
Name:RODRIGUEZ, STEVEN (RPH, CPH)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 NW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-6051
Mailing Address - Country:US
Mailing Address - Phone:305-431-6842
Mailing Address - Fax:
Practice Address - Street 1:4101 RAVENSWOOD RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5373
Practice Address - Country:US
Practice Address - Phone:754-365-3602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU9251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist