Provider Demographics
NPI:1811480908
Name:RODRIGUEZ, HERIBERTO JR (MD)
Entity type:Individual
Prefix:
First Name:HERIBERTO
Middle Name:
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746721
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6721
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:601 TERRY PKWY STE O
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-4300
Practice Address - Country:US
Practice Address - Phone:504-534-1229
Practice Address - Fax:504-553-1176
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2023-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125.072987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine