Provider Demographics
NPI:1700627585
Name:RODRIGUEZ, MONICA (MSN APRN CNM)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSN APRN CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14336 BREDA CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9034
Mailing Address - Country:US
Mailing Address - Phone:786-223-4457
Mailing Address - Fax:
Practice Address - Street 1:805 E OAK ST STE 1
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4576
Practice Address - Country:US
Practice Address - Phone:407-933-0021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNM09309367A00000X
FLAPRN11032162207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife