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Organization

IVAN D RODRIGUEZ D O P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVAN D RODRIGUEZ DO (PRESIDENT)
(305) 824-0706
Entity
Organization

Contact information

Practice address
7100 W 20TH AVE, SUITE 504, HIALEAH, FL 33016-1897
(305) 827-3330
(305) 824-4699
Mailing address
7777 NW 167TH TER, MIAMI LAKES, FL 33016-8452
(305) 824-0706
(305) 824-4699

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
OS7908
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267179400
FL
Enumeration date
10/19/2006
Last updated
12/03/2007
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