# RODRIGUEZ MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rodriguez MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568778306
- **Authorized official:** MR. NEVILLE STREET (MANAGER)
- **Authorized official phone:** (650) 888-2848

## Contact information

- **Practice address:** 771 OLD NORCROSS RD, TERRACE PARK MEDICAL CENTER; SUITE 120, LAWRENCEVILLE, GA 30046-4386
- **Practice address phone:** (770) 670-6920
- **Practice address fax:** (770) 670-6927
- **Mailing address:** 771 OLD NORCROSS RD, TERRACE PARK MEDICAL CENTER; SUITE 120, LAWRENCEVILLE, GA 30046-4386
- **Mailing address phone:** (770) 670-6920
- **Mailing address fax:** (770) 670-6927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2010
- **Last updated:** 10/14/2015