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Individual

DR. CARLOS M RODRIGUEZ MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 792-2211
(941) 794-6199
Mailing address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 761-1998
(941) 794-6199

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME69006
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110169971
RAIL ROAD MEDICARE
FL
01
27594
BCBS
FL
05
379304400
FL
Enumeration date
09/19/2005
Last updated
02/01/2022
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