Provider Demographics
NPI:1245471077
Name:RODRIGUEZ, ANA L
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8728 BRIERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4815
Mailing Address - Country:US
Mailing Address - Phone:904-732-7501
Mailing Address - Fax:
Practice Address - Street 1:8728 BRIERWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4815
Practice Address - Country:US
Practice Address - Phone:904-732-7501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688611696Medicaid
FL688611697Medicaid