Provider Demographics
NPI:1144479114
Name:RODRIGUEZ, LUCILA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCILA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10441 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7313
Mailing Address - Country:US
Mailing Address - Phone:305-551-2323
Mailing Address - Fax:
Practice Address - Street 1:1321 NW 13TH ST
Practice Address - Street 2:CHS (7TH FLOOR)
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1603
Practice Address - Country:US
Practice Address - Phone:786-263-4131
Practice Address - Fax:784-263-4442
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME704812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14694OtherJMH PHYSICIAN NUMBER