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Individual

DR. LUIS JACOMINO RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
4695 W 4TH AVE, HIALEAH, FL 33012-3937
(305) 825-8888
(305) 825-9909
Mailing address
4695 W 4TH AVE, HIALEAH, FL 33012-3937
(305) 825-8888
(305) 825-9909

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN0013832
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071356200
FL
Enumeration date
07/07/2006
Last updated
02/18/2013
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