Provider Demographics
NPI:1700699915
Name:LISET RODRIGUEZ OD PLLC
Entity type:Organization
Organization Name:LISET RODRIGUEZ OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISET
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-904-5656
Mailing Address - Street 1:1680 W 56TH ST APT C223
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2048
Mailing Address - Country:US
Mailing Address - Phone:305-904-5656
Mailing Address - Fax:
Practice Address - Street 1:5372 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2165
Practice Address - Country:US
Practice Address - Phone:305-362-4020
Practice Address - Fax:305-362-2592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty