Provider Demographics
NPI:1902357775
Name:RODRIGUEZ, ROGELIO EFREN (ARNP)
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:EFREN
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2000 NW 87TH AVE # 101-102
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2654
Mailing Address - Country:US
Mailing Address - Phone:844-665-4827
Mailing Address - Fax:877-762-0841
Practice Address - Street 1:4850 W OAKLAND PARK BLVD STE 136
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7277
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:877-762-0841
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9408018363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology