Individual
GERARDO RODIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7250 NW 11TH ST, DORAL, FL 33126-1903
(786) 399-8621
Mailing address
112 SW 76TH CT, MIAMI, FL 33144-2430
(786) 399-8621
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
2329281
FL
335G00000X
Medical Foods Supplier
2329281
FL
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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