Provider Demographics
NPI:1205668225
Name:RODRIGUEZ GUISAO, ARISLEYNIS
Entity type:Individual
Prefix:
First Name:ARISLEYNIS
Middle Name:
Last Name:RODRIGUEZ GUISAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 PINELAND DR APT 1144
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5392
Mailing Address - Country:US
Mailing Address - Phone:469-632-3970
Mailing Address - Fax:
Practice Address - Street 1:5880 ASHMILL DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0033
Practice Address - Country:US
Practice Address - Phone:972-378-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24-304246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant