Provider Demographics
NPI:1811984750
Name:RODRIGUEZ, EVELIO (MD)
Entity type:Individual
Prefix:DR
First Name:EVELIO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-222-5500
Mailing Address - Fax:615-222-5601
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 530
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-222-5500
Practice Address - Fax:615-222-5601
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48350208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527479Medicaid
TN103I333895Medicare PIN
NC2043278Medicare ID - Type Unspecified
NC5901293Medicaid