Individual
GENNY RAFAEL AGUILA RODRIGUEZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10379 CHADBOURNE DR, TAMPA, FL 33624-5011
(813) 562-8116
Mailing address
10379 CHADBOURNE DR, TAMPA, FL 33624-5011
(813) 562-8116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002372
PR
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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