Individual
RAIMUNDO RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 PARK PLACE BLVD., KISSIMMEE, FL 34741-2344
(407) 846-0023
(407) 483-1064
Mailing address
206 PARK PLACE BLVD., KISSIMMEE, FL 34741-2344
(407) 846-0023
(407) 483-1064
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
10/15/2010
Last updated
10/15/2010
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