Provider Demographics
NPI:1952901811
Name:RODRIGUEZ, ALDO (RPH)
Entity Type:Individual
Prefix:
First Name:ALDO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ALDO
Other - Middle Name:
Other - Last Name:RODRIGUEZ-LUVIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:5850 W CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2558
Mailing Address - Country:US
Mailing Address - Phone:702-395-1240
Mailing Address - Fax:702-395-5370
Practice Address - Street 1:5850 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2558
Practice Address - Country:US
Practice Address - Phone:702-395-1240
Practice Address - Fax:702-395-5370
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist