Individual
JOSE RAUL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14551 HOPE CENTER LOOP STE 100, FORT MYERS, FL 33912-4705
(239) 936-2316
(239) 936-3099
Mailing address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 936-3099
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME135835
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME135835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110203500
—
FL
Enumeration date
03/27/2015
Last updated
01/10/2024
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