Organization
RODRIGUEZ MD, LLC
Active
Other names
Rodriguez MD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEVILLE STREET (MANAGER)
(650) 888-2848
Entity
Organization
Contact information
Practice address
771 OLD NORCROSS RD, TERRACE PARK MEDICAL CENTER; SUITE 120, LAWRENCEVILLE, GA 30046-4386
(770) 670-6920
(770) 670-6927
Mailing address
771 OLD NORCROSS RD, TERRACE PARK MEDICAL CENTER; SUITE 120, LAWRENCEVILLE, GA 30046-4386
(770) 670-6920
(770) 670-6927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003105719A
—
GA
Enumeration date
08/30/2010
Last updated
10/14/2015
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