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Individual

JERAMIE LYNN ROSALES RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1034 S BRENTWOOD BLVD STE 1250, RICHMOND HEIGHTS, MO 63117-1263
(314) 328-7958
Mailing address
625 RAYBURN AVE, SAINT LOUIS, MO 63126-1635
(651) 500-4982

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2023048801
MO
2084P0800X
Psychiatry Physician
4301509041
MI
2084P0800X
Psychiatry Physician
89635
SC
2084P0800X
Psychiatry Physician
R4227
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100512670
KY
Enumeration date
04/06/2016
Last updated
02/10/2025
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