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Provider Information for 1912173964

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

RICARDO L RODRIGUEZ MD LLC

Organization Subpart: NO

Organization NPI: 1912173964

Calendar   Last Updated:  2014-04-15
  Certification Date: 

Details

Name Value
NPI 1912173964
Enumeration Date 2008-04-30
NPI Type 2- Organization
Status Active
Authorized Official Information Name: DR. RICARDO LUIS RODRIGUEZ M.D.
Title: OWNER/SURGEON
Phone: 410-494-8100
Mailing Address 1300 BELLONA AVENUE SUITE C
LUTHERVILLE-TIMONIUM, MD 21093
United States

Phone: 410-494-8100 | Fax: 410-494-0815
View Map External Link
Primary Practice Address 1300 BELLONA AVE SUITE C
LUTHERVILLE, MD 21093
United States

Phone: 410-494-8100 | Fax: 410-494-0815
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193400000X SINGLE SPECIALTY GROUP
208200000X - Plastic Surgery
MD D41395