Organization
ATOS DERMATOPATHOLOGY PLLC
Active
Other names
Advocate Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS FREDERICO RODRIGUEZ M.D. (OWNER)
(312) 502-9389
Entity
Organization
Contact information
Practice address
21300 N JOHN WAYNE PKWY, #116, MARICOPA, AZ 85139-8979
(312) 502-9389
Mailing address
2349 E BECKER LN, PHOENIX, AZ 85028-3105
(312) 502-9389
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
42919
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
867831
—
AZ
Enumeration date
09/07/2016
Last updated
09/07/2016
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