Organization
NEUROPHYSIOLOGY DIAGNOSTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL MIGUEL RODRIGUEZ MD (MANAGER/OWNER)
(813) 871-2853
Entity
Organization
Contact information
Practice address
4102 N MACDILL AVE UNIT B, TAMPA, FL 33607-6717
(813) 871-2853
(813) 877-1609
Mailing address
4102 N MACDILL AVE UNIT B, TAMPA, FL 33607-6717
(813) 871-2853
(813) 877-1609
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293D00000X
TAXONOMY
—
Enumeration date
09/06/2019
Last updated
09/09/2019
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