Individual
FULVIA RODRIGUEZ CONN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 272-2244
(813) 272-3766
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 272-2244
(813) 272-3766
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME57161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002729200
—
FL
01
—
54557
BLUE SHIELD OF FL
FL
Enumeration date
07/24/2006
Last updated
05/17/2016
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