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Individual

MR. ENRIQUE RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSA

Contact information

Practice address
765 CREAKWATER TERRACE, APT. 205, LAKE MARY, FL 32746
(856) 203-5655
Mailing address
765 CREAKWATER TERRACE, APT. 205, LAKE MARY, FL 32746
(856) 203-5655

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000374
IL
246ZC0007X
Surgical Assistant
Primary
SA0118
DC
246ZC0007X
Surgical Assistant
FL

Other

Enumeration date
04/25/2011
Last updated
08/19/2014
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