Individual
WAYNE D RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR STE 2G, MELBOURNE, FL 32901
(321) 549-0528
(321) 722-3843
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME35594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067516400
—
FL
01
—
390005081
RR MEDICARE
FL
Enumeration date
12/07/2005
Last updated
10/31/2018
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