Provider Demographics
NPI:1831517085
Name:RODRIGUEZ, LIZ MABEL (MD)
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:MABEL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E STATE ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4354
Mailing Address - Country:US
Mailing Address - Phone:614-566-9718
Mailing Address - Fax:
Practice Address - Street 1:285 E STATE ST
Practice Address - Street 2:SUITE 670
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4354
Practice Address - Country:US
Practice Address - Phone:614-566-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL137382207R00000X
KY56209208M00000X
390200000X
IN01089971A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program