Individual
JESSICA M RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 BRUCE B DWN BLVD # 105, TAMPA, FL 33612-3803
(813) 259-8700
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
ME132860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021902500
—
FL
01
—
DX4TM
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/30/2010
Last updated
10/27/2020
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