Provider Demographics
NPI:1619716495
Name:LISBET RODRIGUEZ BOLOIX PA
Entity type:Organization
Organization Name:LISBET RODRIGUEZ BOLOIX PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISBET
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ BOLOIX
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-822-4447
Mailing Address - Street 1:14869 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3335
Mailing Address - Country:US
Mailing Address - Phone:305-822-4447
Mailing Address - Fax:305-822-4484
Practice Address - Street 1:5801 NW 151ST ST STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2437
Practice Address - Country:US
Practice Address - Phone:305-822-4447
Practice Address - Fax:305-822-4484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty