Individual
MARISOL ORTEGA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 NW 97TH ST, MIAMI, FL 33147-2233
(786) 376-2718
Mailing address
3200 NW 97TH ST, MIAMI, FL 33147-2233
(786) 376-2718
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
11016966
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
11016966
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11016966
LICENSE NUMBER
FL
Enumeration date
12/14/2021
Last updated
12/14/2021
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