Provider Information for 1912173964
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RICARDO L RODRIGUEZ MD LLC
Organization Subpart: NO
NPI: 1912173964
Last Updated: 2014-04-15
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912173964 | ||||||||
| Enumeration Date | 2008-04-30 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: Dr. RICARDO LUIS RODRIGUEZ M.D. Title: Owner/Surgeon Phone: 4104948100 | ||||||||
| Mailing Address | 1300 BELLONA AVENUE SUITE C LUTHERVILLE-TIMONIUM, MD 21093 United States Phone: 410-494-8100 | Fax:410-494-0815 | ||||||||
| Primary Practice Address | 1300 BELLONA AVE SUITE C LUTHERVILLE, MD 21093 United States Phone: 410-494-8100 | Fax:410-494-0815 | ||||||||
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