Individual
DR. WILSON OMAR RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
217 E CENTRAL AVE, WINTER HAVEN, FL 33880-6312
(407) 315-3637
Mailing address
PO BOX 532, LAKE ALFRED, FL 33850-0532
(407) 315-3637
(407) 358-3440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2146-PA
PR
363AM0700X
Medical Physician Assistant
Primary
TPPA690
FL
Other
Enumeration date
04/29/2024
Last updated
05/24/2024
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