Provider Demographics
NPI:1538146154
Name:RODRIGUEZ, FERNANDO D (RPH)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:D
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 43RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6652
Mailing Address - Country:US
Mailing Address - Phone:507-288-8171
Mailing Address - Fax:
Practice Address - Street 1:MAYO CLINIC PHARMACY EISENBERG
Practice Address - Street 2:201 WEST CENTER STREET
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-266-7416
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113618-0183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist