Individual
JESSICA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3654 SW 30TH AVE, PALM CITY, FL 34990-3700
(772) 210-7555
(772) 266-8207
Mailing address
3654 SW 30TH AVE, PALM CITY, FL 34990-3700
(772) 210-7555
(772) 266-8207
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11013304
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407805021
GROUP NPI ASSOCIATION
—
01
—
15154379
CAQH
—
01
—
NX369
MEDICARE PTAN
—
Enumeration date
05/19/2021
Last updated
09/06/2023
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