Individual
MICHAEL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20325 N 51ST AVE STE 154, GLENDALE, AZ 85308-4622
(623) 900-4740
(855) 398-9290
Mailing address
20325 N 51ST AVE STE 154, GLENDALE, AZ 85308-4622
(623) 900-4740
(855) 398-9290
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
006885
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006885
AZ DO LICENSE
AZ
05
—
117932
—
AZ
Enumeration date
07/15/2011
Last updated
10/11/2019
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