Provider Demographics
NPI:1497859722
Name:FALCON RODRIGUEZ, TANIA (MD)
Entity type:Individual
Prefix:DR
First Name:TANIA
Middle Name:
Last Name:FALCON 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:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:5979 VINELAND RD STE 206
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7855
Practice Address - Country:US
Practice Address - Phone:407-352-9300
Practice Address - Fax:407-351-6509
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15443208D00000X
FLACN592208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22730-FAOtherTRIPLE S (SSS)
FL014186200Medicaid
FL014186200Medicaid
PR0022730Medicare ID - Type Unspecified