Individual
DR. RICHARD G RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 LOOKOUT PL, MAITLAND, FL 32751-4491
(407) 215-0400
(407) 215-0402
Mailing address
210 LOOKOUT PL, MAITLAND, FL 32751-4491
(407) 215-0400
(407) 215-0402
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0060714
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055953900
—
FL
01
—
1206414
UNITED HEALTHCARE MEDICAID
—
01
—
14420
BLUE CROSS BLUE SHIELD
—
01
—
204965420
UNITED HEALTHCARE
FL
01
—
298310
AVMED
FL
01
—
4369420
AETNA
FL
01
—
4400683017
CIGNA
—
01
—
937409
UNITED HEALTHCARE
—
01
—
ME0060714
LICENSE
FL
Enumeration date
04/14/2006
Last updated
03/07/2023
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