Provider Demographics
NPI:1770304289
Name:RODRIGUEZ, JOSHUA ALEXANDER (DNAP, CRNA)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALEXANDER
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DNAP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 N ST ELIAS
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-7740
Mailing Address - Country:US
Mailing Address - Phone:480-229-2043
Mailing Address - Fax:
Practice Address - Street 1:4320 N ST ELIAS
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-7740
Practice Address - Country:US
Practice Address - Phone:480-229-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ315858367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty