Basic Information
| Provider Information | |||||||||
| NPI: | 1427384403 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | CARMEN | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 WINDERLEY PL | ||||||||
| Address2: | SUITE 1400 | ||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327517267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072002700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 WINDERLEY PL | ||||||||
| Address2: | SUITE 1400 | ||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327517267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072002700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2009 | ||||||||
| LastUpdateDate: | 07/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP10034479 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME114929 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.