Individual
JORGE EVALDO RODRIGUEZ NYLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W THOMAS RD STE 900A, PHOENIX, AZ 85013-4223
(602) 406-3540
Mailing address
2520 W PARK AVE, CHANDLER, AZ 85224-3970
(520) 270-6515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
69418
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
05/15/2023
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