Basic Information
| Provider Information | |||||||||
| NPI: | 1275723991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ SIGUENAS | ||||||||
| FirstName: | OSCAR | ||||||||
| MiddleName: | HERNAN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RODRIGUEZ | ||||||||
| OtherFirstName: | OSCAR | ||||||||
| OtherMiddleName: | HERNAN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 62707 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339062707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399313440 | ||||||||
| FaxNumber: | 2399313458 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 COLONIAL BLVD STE 203 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399313440 | ||||||||
| FaxNumber: | 2399313458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2007 | ||||||||
| LastUpdateDate: | 08/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | ME108960 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 003386900 | 05 | FL | MEDICAID |