Individual
KENNETH DAVID RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-6000
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35-121559
OH
207Y00000X
Otolaryngology Physician
MT191419
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086732
—
OH
Enumeration date
08/10/2009
Last updated
01/06/2021
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