Provider Demographics
NPI:1265214282
Name:RODRIGUEZ HERNANDEZ, WILMAIDY
Entity type:Individual
Prefix:
First Name:WILMAIDY
Middle Name:
Last Name:RODRIGUEZ HERNANDEZ
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 1:3018 W SIGNATURE DR APT 1401
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-6459
Mailing Address - Country:US
Mailing Address - Phone:787-702-8208
Mailing Address - Fax:
Practice Address - Street 1:3018 W SIGNATURE DR APT 1401
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-6459
Practice Address - Country:US
Practice Address - Phone:787-702-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program