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Individual
DR. MARIBEL RODRIGUEZ-SCOTT
Active
Individual
DR. MARIBEL RODRIGUEZ-SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1134
SC
208D00000X
General Practice Physician
Primary
1134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011347
—
SC
01
—
10167
SC PCF
SC
01
—
1134
STATE LICENSE NUMBER
SC
01
—
12706
BROAD CERTIFICATION
IL
01
—
42D1077950
CLIA
SC
05
—
GP4815
—
SC
01
—
JBM04730
JUA
SC
Enumeration date
08/19/2005
Last updated
09/17/2024
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