Individual
MR. CARLOS ANTONY RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
92- 958 PANANA STREET, UNIT 22, KAPOLEI, HI 96707-6604
(202) 361-6286
Mailing address
92-958 PANANA ST, UNIT 22, KAPOLEI, HI 96707-1329
(202) 361-6286
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/28/2011
Last updated
10/21/2011
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