Organization
ISMAEL RODRIGUEZ M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAEL RODRIGUEZ M D P A (PRESIDENT)
(904) 276-6977
Entity
Organization
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(904) 276-8500
Mailing address
PO BOX 1779, ORANGE PARK, FL 32067-1779
(904) 276-6977
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ME72759
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270550800
—
FL
Enumeration date
07/25/2007
Last updated
05/06/2008
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