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Organization

PAUL A RODRIGUEZ DO PA

Active
Other names
VIP PAIN MEDICINE LLC
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL A RODRIGUEZ D.O., P.A. (DIRECTOR, PRESIDENT,SECRETARY,TREAS)
(954) 941-0484
Entity
Organization

Contact information

Practice address
1821 NE 25TH ST, SUITE 100, LIGHTHOUSE POINT, FL 33064-7744
(954) 941-0484
(954) 941-0485
Mailing address
1821 NE 25TH STREET, SUITE 100, LIGHTHOUSE POINT, FL 33064
(954) 941-0484
(954) 941-0485

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS7048
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
257541800
FL
01
285366
AVMED
FL
01
49427
BCBS
FL
01
DQ2139
RAILROAD MEDICARE
FL
01
L4QH7
FLORIDA BLUE
FL
Enumeration date
08/07/2006
Last updated
04/11/2017
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