Individual
MR. MICHAEL J. RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUBMARINE IDC
Contact information
Practice address
822 CLARK ST., NSSC MEDICAL SUITE 400, PEARL HARBOR, HI 96860
(808) 473-3771
(808) 473-3109
Mailing address
USS KEY WEST #SSN722, FPO, AP 96683-2402
(808) 471-5625
(808) 473-3109
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7383
TRICARE
IL
Enumeration date
11/05/2009
Last updated
11/05/2009
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