Provider Demographics
NPI:1952964728
Name:RODRIGUEZ GARCIA, FABIOLA (MD)
Entity type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:RODRIGUEZ GARCIA
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 1:959 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-7092
Mailing Address - Country:US
Mailing Address - Phone:787-603-0117
Mailing Address - Fax:
Practice Address - Street 1:1510 E FLOWER ST BLDG 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5656
Practice Address - Country:US
Practice Address - Phone:602-287-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine