Individual
CAROL S. RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4949 S CONGRESS AVE STE B, LAKE WORTH, FL 33461-4731
(561) 433-8500
(561) 641-6821
Mailing address
4949 S CONGRESS AVE STE B, LAKE WORTH, FL 33461-4731
(561) 433-8500
(561) 641-6821
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
50492
FL
207W00000X
Ophthalmology Physician
ME 50492
FL
208VP0014X
Interventional Pain Medicine Physician
ME 50492
FL
Other
Enumeration date
08/10/2009
Last updated
08/11/2014
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