Provider Demographics
NPI:1336820638
Name:RODRIGUEZ, FERMIN JOSHUA SORIANO III
Entity Type:Individual
Prefix:
First Name:FERMIN JOSHUA
Middle Name:SORIANO
Last Name:RODRIGUEZ
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 COVE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6463
Mailing Address - Country:US
Mailing Address - Phone:650-455-9315
Mailing Address - Fax:
Practice Address - Street 1:2503 COVE CREEK CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6463
Practice Address - Country:US
Practice Address - Phone:650-455-9315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60975417163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical