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Individual

MR. NICOLAS RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2632 SW PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34953-2845
(772) 873-8811
Mailing address
1564 SE ROYAL GREEN CIR, APT U102, PORT SAINT LUCIE, FL 34952-4674

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
08/31/2013
Last updated
01/15/2020
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